Monroe s01e05 Episode Script

Episode 5

- What did you tell Bremner about me and her? - Nothing.
I guessed about you two.
So Rosario's.
Can we go back to making jokes about her being a lesbian? Or do you need some healing time? Don't know what you were thinking? I didn't even know you could think! I came home because I thought you'd be sitting here staring at the walls! Wednesday night is is poker night.
I enjoyed last night.
So did I.
What was your favourite bit, the sex or the drugs? My personal highlight was your two-hour deconstruction of the first Oasis album.
- I thought you'd like that! I won't kiss you goodbye.
Just so you know.
I'd like to kiss you.
Likewise.
Very much so.
Clear? Clear.
Hello.
So, how long do you and the Snow Queen intend to keep this up? - Keep what up? - All this coming in separately nonsense so nobody knows you're boyfriend and girlfriend.
Can we not call her my girlfriend! Just feels so wrong at our age.
Dominatrix and Gimp it is.
Tell me you didn't play your ironic disco mix! - I did, and she completely got it.
- Ah, but alas she is a girl she has no strong musical opinions.
- She loves music.
- Yeah, let me guess: Scissor Sisters, Will Young, Beyonce, and Jools Holland Big Band.
I'm right, aren't I? Nice to see you're still friends.
Sally Fortune, the only woman in the whole world left who is speaking to me.
Please give me news from the land we call The Surgery? Elective acoustic neuroma.
Lefthand side.
Compression of the seventh nerve.
Andrew Burgess, age 51.
Homeless.
History of headaches and nausea.
Unsteady on his feet.
- Singing in his ears.
- Singing in his ears? Sorry.
Ringing in his ears.
His GP put it down to alcohol and drug consumption.
But I saw him in clinic last month and I did some tests.
Did you run tests for singing in his ears or ringing in his ears? Tinnitus.
High frequency hearing loss.
MRI scan confirmed a large acoustic neuroma.
Booked him in for surgery.
You said I could do most of the operation.
You're still up for that? It's a challenging procedure for one so young and so short.
- Yes, I'm ready.
- Really? You look like shit.
It's a bad day for a hangover.
- I'm fine! I'm fine.
- All right.
So cancellation time.
Bypass versus aortic root replacement.
Your call, Dr Witney.
Mrs Graves versus Mr Cook.
Well, I have seen a lot of bypasses.
So your criteria for rejection is their training value for you.
- Is that wrong? No, that is impressively ruthless.
You are late, Dr Mullery.
So I'd like you to explain to Mrs Graves that we're cancelling her surgery today and that we'll book her in for next Thursday.
The complete removal of a large acoustic neuroma is one of the greatest challenges of the neurosurgeon.
The more of the tumour we leave behind the faster it'll recur.
The more we remove the greater the risk for the patient having a paralysed face.
Wilson, any idea why this is the perfect patient for Fortune to be practising on? - Size of the tumour? Size of the tumour, the skill of the surgeon, the poverty of the patient.
I know you don't mean that.
A homeless alcoholic.
If Fortune makes a mess, he won't call a lawyer.
(# Floral Dance) What is this music? It's our patient's choice.
Is he entitled to a choice? He is homeless.
Fortune, make the incision.
Let's do the craniectomy.
I'd give you a drum roll, but I don't have a snare handy.
Blade.
With a hospital you never know what will happen next.
Like life really.
You're not building up to cancelling my operation, are you, son? I'm afraid it might have to be moved on a few days.
I'm sorry.
It's not gonna happen.
My son's flying in from Australia, so, you know, it's a no.
Well, you bugger off now, son.
I'm trying to listen to my relaxation tapes.
Gerrard the tumour languishes between the trigeminal nerve and the lower cranial nerves.
Fortune, I want you to cusa out the tumour before we get too close to the nerves.
You two might want to take a closer look.
Cusa please.
Springer, I've had enough.
You're squeaking.
I bought some new clothes.
I'm wearing them in.
I don't care for squeaking.
Consider yourself told.
Fortune, the cusa.
Oh! Get her out of here.
Come on.
Get her some air.
Now! Come on! Come on.
I've got you.
Take my hand.
I can close the dura, if you like.
As you said he's hardly gonna sue.
I was being ironic.
As hard as it might be for you to believe, no patient is disposable.
I knew that.
Cusa.
Let's not ruin all Fortune's good work.
Sally? Sally, are you OK? It hurts.
It really hurts.
She fainted during the acoustic.
Quite reassuring.
I thought it was just me.
I'll get some oxygen.
She wouldn't just faint for no reason.
Come on, then.
Nice to see I've still got it.
Sorry.
Oh, Christ! My head.
I won't ask if you're feeling any better.
Can you do something about that light? Of course.
So when did the headache start? Last night, and got worse this morning.
Like being hit with an iron bar.
Did you fall or hit your head? No.
Any exertions, straining? Coitus? I don't think now is a good time to be shy.
I had sex last night.
I've been feeling really sick ever since.
I know the feeling only too well.
Can you get me something for the pain? Morphine.
You know better.
If I give you morphine, how can I tell if it's the illness or the drug making you drowsy? Monitor me and you can find a way round that.
I forgot you knew about this stuff.
I'll see what Shepherd can do.
What do you think is happening? Pain.
Vomiting.
Sensitive to light.
Neck stiffness.
I'd order me a CT scan and look for the blood.
You're good, Fortune.
Monroe.
I'm scared.
Really, really scared.
Shit.
Subarachnoid haemorrhage.
Biggest risk, Wilson? A rebleed gives her only a one in three chance of survival.
So we stop the aneurysm and clip it fast.
Wouldn't we want to coil it? No.
The neck's too wide.
We have to clip that bastard without bursting it.
Her family? Parents in the States.
Her brothers abroad.
Friends? She kept to herself.
Springer, you'd have tried to bed her with your public school sense of entitlement.
She was almost my boss.
I thought you were ambitious.
Good news I hope.
She has an underlying heart condition.
Not good news.
She warned me she had a valve replacement as a teenager.
The bleed may be caused by infective endocarditis.
That would make sense, if I knew what it was.
That was a joke by the way.
Yes, and I'm laughing inside.
So I've ordered an echo and bloods.
Let's just hope we can treat it with antibiotics.
OK.
Operating on a colleague is a lot more difficult.
All the defence mechanisms we build don't work.
I won't judge anybody who doesn't want to do this, but If you're gonna pull out, it's best you do it now.
I'm in.
Everyone else in? Yes.
Yes.
Good.
I was lying when I said I wouldn't judge you for backing out.
Sorry, Mrs Graves.
Mullery.
Mullery.
Mullery, look.
There's no need to go storming off.
It's my fault.
Look, it doesn't matter.
We upset patients every day here.
It's good practice.
It's not that.
It's not Mrs Grace.
Fortune.
It's my fault she had a haemorrhage.
So I'm holding two jacks.
Monroe moves all in with a jack and a nine.
The flop is dealt.
You'll never guess.
It turns up the third jack.
Monroe grins like a Cheshire cat on ecstasy.
I'm thinking: Read these and weep, Mr Twinkle.
Are you listening? Yeah, but I'm not concentrating.
As long as you're listening.
I'm not that mithered to be honest.
Good morning, Ms Fortune.
How's the pain? Shepherd sorted me.
That's cos he couldn't care less.
He's in love.
Really? Do you have a plan? I'll open with a standard pterional craniotomy looking at the carotid artery, stalk the aneurysm down the middle cerebral artery, clip it, get out.
Lunchtime.
Yo! Just my luck! I've wanted to clip an aneurysm for six months.
You can do the next one.
All right? Don't give me your sympathetic look.
You're freaking me out.
I'm sorry.
You're gonna be OK with this, you know.
And if one of the trainees closes the wound, make sure it's Wilson.
Springer sews like a boy.
OK, Fortune.
See you later.
OK.
Let's try and forget who this is and get on with it.
Right.
There you are.
Ragged surface.
It's mycotic, so it has been caused by the heart infection.
Not the right shape.
No-one told it what shape to come as.
Clip applicator, Wickens.
Come on.
Come on! Why are women's brains so angry all the time? Maybe it's something you bring out in them.
Suction! I can't see a fucking thing.
Can't get at it like this.
One of the M2s is in the way.
OK.
This is hopeless.
I'll put a temporary clip in, then we stand a chance.
Shepherd, stopwatch.
Wilson, why are we timing? If you keep the clip on over four minutes you'll starve her brain of oxygen too long.
She'll have a stroke.
Beautifully put.
We'll have to be quick.
Temporary clip.
OK, Shepherd, it's on.
Four minutes and counting.
OK.
Let's see what we can see.
So I'm sorry about my handling of the cancellation.
Mm.
You should be.
Witney tells me you and Fortune engaged in physical intimacy last night.
It's in all the literature.
Intense orgasms can cause a sentinel bleed.
I probably killed her.
Masculinity requires many myths to sustain it, but there is no orgasm on earth that caused an aneurysm by itself.
Fortune's condition can not be put down to your unbridled passion.
I'm sorry to disappoint you.
I hope you realise this bout of self-pity has only set you further behind on your admissions' paperwork.
One minute left, Monroe.
Clip applicator.
OK, Fortune, let me in this time.
Can you just do that please? Come on.
It's 40 seconds.
It's 30 seconds.
OK.
Let's get the clip off the main vessel.
It's gotta come off now, Monroe.
I know.
I know.
It's gotta come off.
Four minutes.
Time's up.
It's off.
That was brilliant! Close her up, see what damage we've done.
How did it go? We didn't kill her.
I just hope we didn't wreck her.
Any news on family or friends? Oh, have you tried asking Mullery? Why would I try asking Mullery? Well, according to Mullery they're involved in some unlikely romantic liaison.
Mullery! Mullery is the mystery coitus? In so many ways.
Who rocked the bed for him? In the circumstances that is a cruel and tasteless remark.
When did you get so sensitive? Him and relationships! He forgets who he really is.
She has someone to sit by her bed, even if it is Dozy Bollocks.
Her family might be here tonight.
Her dad was a surgeon.
Mum was his theatre nurse.
They retired to the States.
San Francisco I believe.
One brother in Mumbai and one in Boston - both surgeons.
The chances of them coming when it really matters aren't good.
How long have you known this? Monroe.
Yes.
Thanks.
Thanks.
I'll be right over.
She's just woken up.
Anything else I should know before we speak? Her first name's actually Salina, not Sally.
It's Hindu.
It means water.
Do you know where you are, Fortune? In ITU.
A hospital would have done.
You don't get bonus points.
You know what's happened to you? I've had a brain operation.
Indeed you have.
If only you'd been there.
Do you know who this is? It's Mullery.
I was gonna tell her to get some rest.
But she's always been one step ahead.
The big worry when someone has had this operation is a stroke.
And the risk of delayed vasospasm.
I did the research.
Good.
She's Fortune, OK? She's indestructible.
By the way in different circumstances I'd be congratulating you.
Because I have to say she is .
.
by any measure way out of your league.
Nick, why are you knocking? I've come to pick up some of Mum's stuff.
Is this it? Yeah.
No need to look so worried.
I'll give you a hand.
Does Mum know? Of course she knows.
She suggested it.
You start in there.
I'm sorry I told Bremner about you and Fortune.
I'm glad you did.
She'll be all right, you know.
I've upgraded your deal.
Don't change anything! Just set it up.
So when are you gonna come back for your Jamiroquai CD? Don't deny it's yours? You might like it to remember me by.
It would remind me of our irreconcilable differences.
So you only went and did it.
I guess I really did.
It's good to be able to picture you here.
It's nice! Thanks.
And thanks for helping, and being so .
.
wellthanks.
Right.
I'm off.
Gotta get the van back.
Give me the keys.
After that journey I'll drive.
Thank you.
Mission accomplished.
You see? Your dad can be mature when he wants to.
Is that what you call it? Would you rather we were at each other's throats? Just don't give up that easily.
You didn't even try.
You helped her move out.
What signal does that send? That it's over, but I still care enough to help her move out.
Christ! It is over.
I have to accept that.
I might not like it, but there it is.
Here.
Buy yourself a decent haircut, will you? Have you got any idea how hard it is to be your son? ã20 isn't adequate compensation? Doesn't begin to cover it.
Drive carefully.
I'll go and You're young.
It's the weekend.
Go buy a shirt you can later regret.
Must be nice to have your own personal Boy Scout.
Yes.
You've no idea why he's doing it, have you? Short-term memory loss.
Very convenient.
OK.
You know the drill.
Shut your eyes.
Turn your palms upwards.
Hold them there.
Is there a drift? Stop cheating.
OK.
Push against me with your thumbs as hard as you can.
Christ! My head.
What did you do in there? I had to use a temporary clip to get at the aneurysm.
Very flash.
OK.
Bring your fingers to your thumbs.
There's a weakness there, isn't there? I've already noticed it.
It's only been one day.
Don't start worrying about that now.
OK.
Got the next round to worry about anyway.
What next round? The heart operation.
What heart operation? When were you gonna tell me? I was about to call.
We have no choice.
The infection can't be treated with antibiotics.
Delay two days.
She doesn't have two days.
She is at huge risk of vasospasm which will kill or cripple her.
Do you prefer she dies of a cardiac failure, but the outcome stays pure? Make you feel better? She's not strong enough.
She isn't.
She has a heart valve in tatters.
If there was any other way, do you - Put her on bypass and her brain will swell.
That could kill her.
The anaesthetist will do his best to cope with that.
Which one? You'll never find a locum on a Saturday.
Shepherd did a cardiac attachment in the States.
He's offered to step in.
Shepherd?! You think I believe that? Shepherd! Why are you doing this to me? It isn't about you.
A colleague needs an emergency op.
So you back Bremner's judgment over mine? It has nothing to do with you and her.
It's to do with me being asked.
By someone you're having sex with.
Ssh.
Has your judgment been skewed by that? I know why you're being like this.
You feel like shit.
What! You're worried she was damaged by the op.
Bollocks! She has a weakness in her left arm she didn't have before.
I will not be lectured on surgery by a glorified plumber.
It's hard enough when it's someone you don't know, let alone someone you do.
Someone you like.
Don't you think I feel that, too? I was part of it.
Remember? So putting her at risk again will make you get over it? As longer as you feel better about it that's the main thing.
How are you feeling? Like a cat on its ninth life.
You'll be all right, you know once all of this out the way.
Don't try and reassure me, Bremner.
I reassure patients every day.
I know too much.
All right.
You tell me what you wanna hear.
The truth.
Of course.
Of course.
You are very ill.
If you weren't, I wouldn't dream of doing this operation so soon.
Your infection is very aggressive.
Your valve is shot.
And your brain will swell as a result of being on bypass.
Anything else I should know? Yeah.
Monroe's not the only great surgeon in this hospital whatever he thinks.
You think he's a great surgeon? Does he know you think that? No.
And he never will.
Goals of surgery? Remove infected tissues.
Deroof abscesses.
Restore cardiac architecture.
Good.
Mullery, where do you think you're going? I'm scrubbing in, aren't I? You are not.
We've enough potential for hysteria without the boyfriend.
You start 50mm above the sinotubular junction.
Starting at the uppermost point of the ascending aorta, then down to the middle of the non-coronary cusp and end obliquely.
The incision permits aortic root enlargement and affords maximal exposure of the aortic valve.
More? No! I've done the course.
You are not scrubbing in.
You really have no feelings at all, have you? For future reference you should know I don't respond well to melodramatic outbursts in hospital corridors.
What are we looking for? Evidence of an aortic root abscess.
Good.
OK, Dr Shepherd? All good this end.
All the better for being called doctor.
Set up, Dr Witney? Median sternotomy, bicaval cannulation Normally at this point Monroe offers me a large cash incentive.
We don't resort to banter in my theatre, Dr Shepherd.
So I'll be using the existing scar to make the entry.
23 blade please.
You don't want something stronger than that? It's not good to be seen drinking in hospitals.
Sorry.
I'll stop now.
Who said anything about stopping? Much as it pains me to say this, Bremner was right to keep you out.
I never had much luck with women.
Could be argued that Fortune is the unlucky one in this set-up.
Must have been some orgasm.
Not exactly a great start, is it? That's true.
Even Ali MacGraw in Love Story waited a few months before keeling over with movie cancer.
The thing is I know everyone thinks I'm not entitled to be this upset.
We've only been on a few dates - Forget it.
Don't see anyone else at her bedside.
Doesn't seem creepy? If you'd hung around her bed and you hadn't been dating, that would be creepy.
And I'm not trying to make her fall in love with me.
Good! The dorsolateral frontal gyrus becomes very active in the first flushes of love.
You wouldn't want her brain coping with that.
Not read that.
Impeccable academic sources.
Research mainly conducted on the female prairie vole.
So not in humans? If anyone ever reminded me of a prairie vole, it's Fortune.
No offence.
None taken.
Make sure the bites are no more than half a centimetre apart.
Keep an eye on that.
Good with the tension.
Too little and you may have to stitch her up again post-operatively.
I wouldn't want to be the one having to explain that to her.
No.
Good.
Just make sure none of this goes to your head.
If this is a poison pen letter, it's not a good time.
Just read.
Ah, your course.
I knew you'd get in.
Well done.
Thank you for the references.
You deserve it.
You're not cut out to be a snack trolley operative.
You frighten the customers.
Mullery.
Mullery! She's come through.
They replaced the valve.
She's doing well.
And her obs? When did you hear? Just now.
Mullery, can I point out this is my office, and you shouldn't be in here.
Fortune came round safe and sound.
I got her off the bypass like I'd done it all my life.
Don't torture me with details of your adultery, you swine! Well done! OK.
Enough's enough.
Strong displays of emotion are only permissible in relation to gambling, football results, and flatulence.
I mean it.
This room is the last refuge for traditional masculinity.
So from a personal point of view, who's the better surgeon? Me or Bremner? I think you have the better drugs.
I just wanted to say sorry about what I said before.
Wellit can't be easy having your relationship be the subject of tittle-tattle all over the hospital.
No.
It doesn't bother me.
It's a compliment, if you think about it.
I'm not sure that I follow.
Why wouldn't I want people talking about me? No need to look so worried.
You came through it.
Now you just have to get well again.
When you have a haemorrhage you kind of stop knowing where your body ends and the rest of the world begins.
And slowlybit by bit .
.
it starts to come back.
Your face.
Your tongue.
Your arms.
Your legs.
The tips of your toes.
And your fingers.
Except not my fingers.
This left handfeels like a friend that won't come back to me.
It will.
I promise.
If it doesn't, I'll never perform surgery again, will I? It will come back.
I promise as a friend and as a demigod.
Better make way for the emotional therapy.
Go easy on her.
I will.
Oh.
And, Mullery, no orgasms for the first few days, superstud.
Don't worry.
I don't intend to have any.
Hello.
I will never say this again, so listen.
You were right.
I was wrong.
Not now.
I'm not in the mood.
Did you hear what I just said? Don't think I don't know what you're up to.
What? Greasing round Monroe cos you can't impress Bremner.
My girlfriend has just had brain surgery.
And you took advantage of it to advance your career chances.
You should be ashamed of yourself.
Did something come up? Yes.
Sorry.
That's OK.
I'll wait.
There's no need.
I've been sitting in the car for 20 minutes.
It's no hardship to be sitting in here.
That your way to say you're annoyed? I'd rather you just said it.
No.
I'm just saying That I inconvenienced you.
Why else would you say it? Why are you spoiling for a fight? Because I find it difficult having someone waiting for me in this way.
Having any expectations.
Everything that goes with that.
I feel I should apologise.
I'm not sure what for.
No, no.
You really don't need to apologise.
You're a good man.
Right.
Well, that's settled.
Which is probably why it's better if we stop seeing each other.
Again? Yes.
Again.
I've been doing some reading.
And it might take a few months to recover full use of your left arm.
Finger flexion can be the last thing to return, especially when the precentral gyrus has taken a hit.
That would be reassuring if you weren't a heart specialist.
I might have to change specialism anyway.
I insulted Bremner.
Oh, dear.
I hope it wasn't on my behalf.
I like to think it's on behalf of all the downtrodden trainees everywhere.
Hey.
Come on.
Let's go on a date.
Jenny! You don't get away that easily.
Cos I've done everything right, and it's still the wrong thing.
That's the point.
What? You're too good, too reliable to string along for reasons I'd rather not go into.
It just isn't for me.
I'm sorry.
What is wrong with you? It's like they took the bit out of you that allows you to be happy.
Maybe they did.
Oh! Don't tell me.
Don't tell me.
Is it Lion King 2, Simba's Pride? You still haven't got that haircut.
I just wanted to say sorry before I went back - in person.
About the other night.
Well, I'm sorry for everything else.
Right.
Good.
You don't really have to go back now, do you? How's the philosophy going? Don't say, 'I told you so.
', but it's a bit wanky.
Is that a direct quote from Plato or are you paraphrasing it? Cheers.
Cheers.
Are you sure you wanna do this? Yeah.
Good way to remind ourselves it wasn't all bad.
I suppose.
Come on.
Let's go back to the days when your dad had hair and you didn't.
Oh, my God! Is that Charlotte or is that you? It's Charlotte.
I remember her raggie.
I didn't have a raggie.
I had snakey.
So you did.
Man make fire! You're not serious about leaving? I don't believe in assessments, Dr Witney, but competition.
I couldn't share my pain with you.
You don't have to tell me this.
I'm asking you to operate.
Will you help me fight?
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