ALWAYS
AND
EVERYONE

Episode 12

Episode Summary:-

It's another night shift - and I think 'chaos' describes it reasonably well, again... In the first seven minutes (!) of the episode we have: -
       Yvonne writing up the waiting time for non-urgent cases to six hours:
       Almost in passing, two patients with bleeding head injuries and one with a bleeding hand;
       Mrs Margaret Scott, brought in as a 'collapse query cause' - old, confused, suffering from
atrial fibrillation, whose carer (her daughter) had rung for the ambulance before leaving for a holiday...
       The 'star' case of the episode - Warren Johnson, whose vehicle suffered a blow out and crash, resulting in a pneumothorax (collapsed lung), broken leg, cuts and bruises - and his being impaled on a 3 foot fencing post...
       A triple
A patient;
       Alex Cowley, stricken by severe abdominal pain while driving (and who sensibly stopped rather than endanger others by trying to carry on) - turns out it's a perforated ulcer.
       Mr Potter, a heavy smoker suffering from (surprise surprise!) chest pains and shortness of breath...
       And that's without mentioning the eleven 'stopovers' from last night still waiting for beds, the other non-urgent patients filling the corridors and cubicles, the fact that, as Cathy complains, there's only one emergency theatre for nights (Rob's "We've been here before, Cathy - deal with it." may be true, but is hardly helpful under the circumstances!), the young lad rushed in with EMD half way through the episode, the waiting time jumping from six hours to eight hours... I think I'd have gone home and tried to get a doctor's appointment the following day!!

It was good to see Kate beginning to fulfil her potential. I would assume her first reaction would be that she'd missed something and inadvertently caused Margaret Scott's death - but she knows that she did everything absolutely correctly. Fast thinking when she and Juliet found the old woman dead, too - no point in alarming the other people nearby. And despite the circumstances she's feeling more confident as well - calling Robert by his first name and standing up for herself. It was nice to see Mike supporting her, as well.
       David may be Rob's protégé, but he still needs to learn to think beyond the issue of the moment. The medicine is still his major concern (shown by his examining the woman in the corridor regardless of considerations of modesty), but sending an unaccompanied and obviously annoyed relative into resus..?
       And on that subject, while it's uncomfortable to think that anyone would behave in such a way in a ward full of obviously suffering people, Lawrence Scott's actions aren't uncommon. It's why hospital staff now carry personal alarms. Which in itself is an appalling indictment of the sort of society in which we live. But I'm not going to start on that topic...
       I'm not surprised Terry snapped. He's having a dreadful day anyway: everyone's stressed out, but it seems to have got to him more than usual. I admire him for going to Chris's rescue - though, given his nature, it's difficult to imagine him reacting in any other way. I hope David feels properly chastened. After all, it was his fault!
       Interesting the way the Rob/Chris relationship is developing - and it's nice to see them (well, Chris anyway. I get the impression Rob isn't particularly perceptive) being honest with each other. If that's what it actually was...

              [Rob] "You still worried about speculation?"
              [Chris] "I'm worried we're fooling each other. I want a career, Robert. I practically gave up my marriage because I wanted a career. What is it that you want?"

And later: -

              [Chris] "I don't want to fill any part of the space that Issy left."

       And later still: -
              [Rob] "I want you to stay because this is a better place when you're here, and I mean that professionally and personally... We can be a team, Chris."
              [Chris] "Equals?"
              [Rob] "Yeah - if you'll
let me..."
              [Chris] "We should only ever be colleagues."

       (Oh yeah..? Of course we believe you!...)

Actually, I'm sure Chris does believe it, even if it means fighting against her own instincts. And Rob? I'm not sure about Rob. He'd certainly miss her dreadfully if she did leave - but that would be more because she's not just a great team member, but also a good friend, one who is prepared to disagree and scold when it's needed. Yes, I do think his "I wish!" was meant (mostly) sincerely - but I also think the 'speculation' came as a surprise to him, and not necessarily a pleasant one.
       (Which reminds me - though don't ask me why! - we haven't seen baby Harry for ages...)

There are some truly wonderful one-liners and dialogue in this episode: Warren's "I feel like a kebab..."; Yvonne's referring to Warren as the "man on a stick"; David's "Do not pass go, do not collect sandwiches." to his triple A patient; that great exchange when Warren is being wheeled in -

              [Terry] "Make like a tree, Warren."
              [Stu] "Yeah - no 'o-fence' intended..."

I liked Lou's "There'll be an aspirin waiting for you when you're ready" (I did hear that correctly, didn't I?) to Mr Potter; Rob's comment to Emma, Warren's wife - "Ignore the fence post - he's just trying to scare you."; and my favourite - Terry (to Warren) "What's the weather like in Transylvania?" (I thought they were suppose to keep him still, not have him chuckle!) Beautifully designed to reassure the patient. After all, if those taking care of him can crack jokes, things can't be too bad, can they?

At this point I'll express my pleasure that the obvious pairing off of the staff members hasn't happened! It would have been just a little too easy and convenient. As it is, we're left with unresolved tensions and problems - and some wonderful material for series three!

However, there are also a few things that jar... Despite the long queue of people waiting to be seen, several of the staff take time out to talk about their own problems. I can understand Rob and Chris (just), but Mike and Cathy?...
       And on the subject of the Mike/Cathy situation, why is Mike's moving to London the only resolution to the 'problem' of Paul wanting to live with Stella? Stella wants both of the boys to live with her anyway - if Mike is so keen not to split them, why don't they both go? I can't see Ritchie objecting. It would give Mike some time on his own and with Cathy, a chance to boost his career, and a break from being a single parent. Fair enough, he might not fully trust Stella, but since the preliminary hearing decided in Mike's favour she'd be unlikely, I'd have thought, to do anything to jeopardise the gains she has already made, both with the boys and with Mike. They could come back for holidays, and Mike could phone and visit. It sounds more as though Mike is looking for an excuse to leave...
       But then again, why doesn't Cathy go with him? She's said in the past that she's looking for a way to leave - this would seem an ideal opportunity. If she wants him so badly, why not? Unless of course there's something behind the scenes keeping her at St Vic's...
       She wants Mike, but considers herself "just a lover" and refuses to get involved. But surely, if she wants him that badly, she should get involved. Unless she really is being selfish. Yet she tries to persuade Mike to keep the boys with him (OK, by doing so they'd both be able to stay where they are, avoiding the exigencies of a move) which would mean she'd have less of his time. (Am I tying myself in knots here?)
       All in all, I found these scenes unconvincing. They were obviously meant to tug at the heartstrings, but I'm afraid the lack of sense of it left me unmoved and slightly irritated.

Equally odd, to my mind, is Lou and Stu's relationship. She's having their baby - but doesn't seem to want him to have anything to do with the child. And he doesn't seem too worried about it (though that, of course, could be because he's afraid of driving her away? No, that doesn't feel right either...) Or perhaps he really isn't that interested - although he asks her not to forget he's there, then quips about the child being a football supporter! Hardly supportive, is it? I know Stu is a little on the dour side, but surely he can do better than that.
       And Lou doesn't seem to me to be particularly well equipped, emotionally, for motherhood just now - the child is an 'it' to her... The whole scenario just doesn't work. I shall be very interested to see how it's resolved in the third series.

I have to confess that the first time I watched the episode my immediate reaction was that it was too melodramatic - from a critical viewpoint a definite touch of OTT (although undeniably fine and stirring entertainment). The second time through, I changed my mind - something of a reversal of the usual. Although it is, I would guess, unusual for so many crises to happen at the same time, as a definite 'worst case' scenario the episode worked extremely well. And it managed to show in graphic detail how difficult life can be for those working in the medical profession in this day and age. The vast majority of hospitals simply aren't geared up to coping with the pressures laid upon them. It's not the staff: the staff on the whole are superbly trained and enormously skilled, although there aren't enough of them. But the hospitals themselves are inadequate - too small for the growth of the population (especially the elderly population) of the country. There are more people, and more cars, and greater dangers, than there were when these places were built, and it's getting worse. Seeing patients being treated in corridors, in offices, in ambulances, or having to wait almost literally days for a proper bed, brings home the inadequacies of the infrastructure in a way dry statistics never can. And illustrates the terrible pressures the staff of A&E departments - indeed of all hospital departments - are under, all the time. I have nothing but admiration for them. I would hope that after watching the series, other people will have a little more respect - and patience - for them too.

Joules Taylor, 23rd June 2000.

Notes

The A&E department is now firmly established, in my mind anyway, as the place you go to to stop you dying - and are afterwards moved on to have the problems sorted out more precisely.

Irregular heartbeat. Dangerous if left untreated, but since it was in her notes I'd assume she was on medication for it. Back

Abdominal Aortic Aneurysm. Abdominal rupture of a swollen aorta. Back

Electrochemical dissociation, a type of cardiac arrest. Dr Irvine - "There is some electrical output from the heart but not enough, or strong enough, to make the heart pump as it should." (Quite different from OMD, who are a pop group.) Back

What the hell is that supposed to mean?? Back

It's Chris who tells him "If you shut the doors you're saying our best isn't good enough", and Chris who points out that the team could really do with a pat on the back. She has enormous consideration for the rest of the staff. And she frequently acts to remind him that the team - and himself - are human... Back

I still want to know more about Andrew!



I am indebted, as ever, to Dr Irvine, whose patience and willingness to answer my innumerable questions - and to send me a breakdown of the procedures in each episode - has been absolutely invaluable. The background information she's given me has been a real eye-opener as well, and done nothing but increase my admiration for the whole field of medicine. Thank you, Kate.

© 2000 Joules Taylor


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