Holby Wiki - Casualty and Holby City
Holby Wiki - Casualty and Holby City
This article covers a real-world subject which should not be taken as part of the Holby universe.

Episode 1138 of Casualty is the 46th episode of the show's 33rd series. It was directed by Dafydd Llewelyn and written by Hilary Frankland, Patrick Homes and Katie Douglas.

As a result of episode 42 being postponed due to coverage of the 2019 Wimbledon Championships overrunning, the final episodes of the series were pushed back by a week. Consequently, episodes 46 and 47 were condensed into a single, feature-length episode.

This episode features Amanda Mealing's final scenes as Connie Beauchamp before her sabbatical from the show. It was confirmed in April 2019 that the actor was taking a break from the show, and she returned in January 2020. It also marks the final appearance of porter Gem Dean, portrayed by Rebecca Ryan.


Day one

Connie hands the emergency department's pharmacist Leslie a diazepam prescription, but he informs her that all benzodiazepine prescriptions must be double-signed. She insists that, as Clinical Lead, she does not need permission for a prescription and demands to know who instigated the initiative. Henrik takes responsibility for the decision and asks if it is a problem, and Connie assures him that it isn't.

On their way to the ambulance station, Iain apprises Gem of his discovery of a hard copy of Dirty Harry, and they discuss their plan to watch each of the top 200 greatest films of all time. He asks her if she has heard from Rash, and she tells him that he has been trekking with elephants and intends to visit the islands to see caves. He complains about her constantly using her phone and finds a notification from a flight-booking website advertising a last-minute flight to Thailand for £240. Ruby and Jan encourage her to seize the opportunity to join Rash, but she decides to go to work.

In admin, Connie informs the team that an inquiry will be carried out about the department over-prescribing benzodiazepines, and any benzo prescription will require a second signature from a senior member of medical staff. As she speaks to David, Ciaran delights in the news and claims to Archie that Connie is in "prime screw-up territory". He vows to make sure that he leads the inquiry and that there are witnesses when she succumbs to the pressure. Meanwhile, Holby resident Stuart Daley drops off his daughter Siobhan outside the ambulance station, but Jan sternly instructs him to move out of the way. Siobhan apologises and introduces herself as the new emergency care assistant, and Jan returns the greeting by threatening to give her "her marching orders" if the doors are blocked again and leaves Iain to show her the ropes; he joking advises her to make sure Jan has eaten if she insists on making mistakes.

Back in admin, after receiving a call from the bat phone, Archie informs Connie that there is a warehouse fire, so the department is on major incident standby. Connie instructs her and David to discharge as many patients as possible and increase the temperature in resus. She struggles to think of more urgent tasks, and David suggests retrieving burns charts, clingfilm and fluids. Archie proposes apprising Burns and Plastics and Anaesthetics of the situation, but Connie snaps at her. In her office, she closes her blinds and opens a box file containing a box of diazepam. She contemplates taking a tablet, but she resists the urge and hides it away.

Hanssen asks Connie how many casualties from the fire can be taken in before diversion becomes necessary.

Iain and Siobhan arrive at the burning warehouse, and he assures her that she will be fine as long as she does as she is told. A woman named Aliya is carried out of the building by firemen, and the two medics tend to her injuries. Iain assesses her condition and goes to ask Siobhan for oxygen, but she is one step ahead of him. He intends to insert a line for fluids and analgesia, and she volunteers to prepare them and take over the jaw thrust. In her office, Connie apprises Hanssen of the details of the warehouse fire. He asks her how many patients the department can take before diversion is necessary, and Ciaran interrupts and asserts that they can take all of them if "everyone's on their game"; Connie reluctantly agrees. He also volunteers to conduct the inquiry into the benzodiazepine over-prescription problem, but she claims that she has already requested the records. Hanssen leaves her to lead the inquiry, much to Ciaran's indignation. As she contemplates feeding her drug addiction, she asks Noel to email her the department's script records for the last three months. She then opens the file box and takes a tablet of diazepam.

At the scene of the fire, Aliya begins asking for a man named Josh, and Siobhan suggests asking the fire warden if his name is on their list. Jan and Ruby arrive, and the latter goes to treat Aliya. She continues to ask for Josh, and Siobhan explains to Ruby that Josh was her assistant who left his job some time ago. As Siobhan helps Iain put pressure on a patient's wound, Ruby asks her if she is okay, and Iain assures her that she is "a natural". Once Aliya is taken into resus, Ciaran suggests that Archie assists Connie, but Connie claims that she can manage on her own. She asks for a second IV access and an accurate burns percentage for fluid resuscitation. Jacob asks Aliya if there is someone she wants them to call, but she asserts that there is no-one. However, her husband Sunny rushes into the room.

As Iain and the other paramedics load the last of the patients into ambulances, a firefighter alerts them to a man who has been found in the warehouse with full-thickness burns to her torso. Iain instructs Siobhan to retrieve the ventilator as he performs an intubation. She returns with the equipment, but, once she sees the state of the patient, she begins to have a panic attack and runs back to the ambulance. She leaves a voicemail for Stuart and runs away. Outside the department, Archie offers to pay for Will's food from the food wagon, but he insists on paying for it himself as he knows "what it'll cost [him]". She informs him that there will be an inquiry into the benzodiazepine prescriptions and attests that, in the meantime, Connie is still dangerous. She reminds him that Duffy lost her job because of her, but he argues that she left due to her dementia; she asks him when he will realise that she is unfit to practise. Nearby, Gem tells Rosa that Iain needs her to watch the 200 best films with him, and Rash is waiting for her on his travels; she asks her how she can make them both happy. Rosa suggests choosing happiness, but Gem claims that she cannot leave Iain. She asks her what to do about Rash, and Rosa asks whether it would be kinder to keep him waiting or "cut him loose".

In resus, Connie asks for another line to be put into Aliya, but Jacob points out the abnormal number of lines already in her. She spots Archie watching her and tells her to get on with her work. Sunny asks her how his wife is doing, and she informs him that, due to her full-thickness burns, she will require a skin graft. Aliya recognises one of the other patients as her colleague Mariusz and asks how he is, but Jacob reminds her of patient confidentiality and tells her that he will be moved to HDC. She asks Sunny to contact the next of kin of everyone on the fire warden's list, but he opens up to her about his feelings of dread and uncertainty after hearing about his "wife" being involved in a fire. Meanwhile, Siobhan leaves an off-licence and empties a bottle of water before refilling it with vodka.

Sunny returns from speaking to the fire warden and assures Aliya that everyone is accounted for and okay. She informs him that she is supposed to be meeting her solicitor and going through the divorce papers tomorrow, and he asks her if she wants him to postpone or cancel it. He claims that he does not know how they got to where they are, and she asserts that they started seeing each other as business partners as opposed to a couple. After claiming that she was sick of what they had become and expresses her desire to be looked at the way he used to, the two touch foreheads. As Iain loads the man onto the ambulance, she calls for Siobhan. Ruby offers to ask Jan for someone to drive for him, but Siobhan returns and apologises. When she reminds him that, as an ECA, she is not allowed to travel in the back with such a severely-injured patient, she bites the bullet and goes to drive. In resus, Aliya and Sunny have reconciled, and he accompanies her to the burns unit, but she is horrified when Josh is taken in with severe burns.

Iain admonishes Siobhan for drinking on the job.

Outside the department, Gem asks Iain if he is alright, but he assures her with a poorly-done impression of a line from Dirty Harry. She then leaves Rash a voice message asking him to call her back to discuss an important matter. Connie arrives in resus to perform an escharotomy on Josh. She asks Archie how many times she has performed the procedure; she claims that she has only done it once, so Connie allows her to make the incision. However, they soon lose all output and attempt to resuscitate him. At the ambulance station, Siobhan secretly fills her water bottle with more vodka. However, outside, she finds Stuart who realises that she has been drinking alcohol. He laments on her four weeks of sobriety, and she pledges not to touch another drop. However, she turns around and finds Iain gesturing her to hand over the bottle. He smells the contents and berates her for drink-driving with a patient in the back of the ambulance before calling the police. Stuart asserts that her alcoholism is an illness, but Iain maintains that she cannot "bring that sort of baggage" to work and urges him to consider whether or not making excuses for her behaviour is "the right kind of help".

In resus, Connie, Archie and Robyn continue trying to resuscitate Josh, but he is still asystolic. Archie suggests stopping, and Connie asks for the time of death. On a bench in the carpark, Archie tells Ciaran that Connie "bottled it" and got her to perform the escharotomy instead, and the patient died. He asks her if he would have survived if she had been fully fit for work, and Archie claims that she would not. When he asserts that "the main thing is [that] she'll be rattled", Archie corrects him by reminding him that a man has died. Ciaran subsequently calls Hanssen to discuss the inquiry, leaving Archie staggered. In cubicles, Sunny asks Jacob about Josh's condition, and Aliya is distraught to learn that the medical team failed to save him.

Siobhan returns to her house and is confronted by Stuart. She demands to know where her alcohol is, and he claims that he has poured it all down the drain. They begin to argue until Stuart backs down and asks her what she wants him to do for her. She requests money, but, when he refuses to hand any over, she grabs her car keys and leaves. He tries to block the car's path, but she fails to react in time and accidentally hits him. She apologises, and he assures her that it is not her fault. Meanwhile, as she goes to take a tablet of diazepam, Hanssen and Ciaran enter Connie's office. She informs them that she has been too busy to follow up on the inquiry, and Ciaran offers to take it off her hands, but she insists that it is fine. Asserting that they cannot be seen to be "dragging [their] heels", Hanssen asks Connie to email him the paperwork, and she obliges. Once they leave, she quickly takes all of the remaining diazepam.

David confronts Ciaran about his decision to not divert.

Back in cubicles, Sunny questions why Josh was in the warehouse and did not sign in. He decides to call his parents and asks Aliya to allow him to use her phone to access his HR records, but she claims that she does not know where it is and recommends that he goes outside for some fresh air. She asks Connie where her phone is, and she finds it in a plastic bag containing her belongings. She opens her text conversation with Josh and tries to delete it, but she drops the phone and begins to deteriorate. In the lift, Gem receives a call from Rash, and Rosa volunteers to cover for her while she talks to him. Elsewhere, David confronts Ciaran about his decision not to divert and insists that the department is at full capacity. When he overhears Gem and Rosa discussing where to take their patient after their cubicle is taken, he admonishes them for not using their initiative, but Robyn retorts by suggesting that they move them into the broom cupboard. Ciaran admits defeat and instructs them to move the patient in cubicle 7 to Orthopaedics. Outside, Iain and Ruby arrive with Stuart and Siobhan and apprise Ciaran of the former's injuries. Given that his condition is stable, he tells them to leave him in the ambulance as he is not a priority. Iain challenges him and questions why they were not diverted, but Ciaran maintains that the department is full and tells them to "suck it up". However, Siobhan alerts the paramedics to Stuart fitting.

In resus, Connie informs Aliya that her pulmonary oedema is improving, and Sunny is keen to visit her. However, she demands to know where her phone is, explaining that she has messages on it that she cannot afford to allow him to see. Connie takes issue with having to lie for her, but Aliya claims that she does not want him worrying. In the ambulance, believing that he is having a reaction to the Diazemuls they have given him, Iain and Ruby ask Siobhan if Stuart has had diazepam before; she is not sure. As his respiration rate continues to drop, they quickly insert a guedel and take him into the ED. In her office, Connie calls Hanssen and informs him that she has emailed him the department's prescription records, and she has a delicate matter to discuss with him. Outside resus, Ciaran confronts Iain and warns him not to "pull a stunt like that again" and asserts that Stuart's life was only at risk because he overdosed him on Diazemuls. Ruby defends Iain and asks Ciaran if they should have left him fitting until he sustained brain damage. Once Jan appears, Ciaran brands her paramedics as "way out of line" and accuses them of jeopardising the "smooth running" of the department, but she retorts by suggesting that his system has not "looked smooth all day". She encourages him to put a complaint in writing, and she promises to do the same. Once Ciaran backs off, Iain grins.

Sunny asks Aliya how she is feeling and hands her her phone, explaining that he could not access Josh's files as she has changed her PIN. She admits that she slept with Josh and promises that it did not mean anything. She points out that they have not talked to each other about anything other than work for years and suggests working something out. Devastated, he tells her that, while he will help her recover, he believes that will be "enough" now. At reception, Iain assures Siobhan that Stuart will be okay, and she laments on her father showing more concern for her wellbeing than his own. Realising that she will never be alright carrying on the way she is, she tells Stuart that she has to take responsibility for her actions and urges him to "let [her] go". Despite his objections, Siobhan hands herself into the police. Noel calls Gem over and hands her an envelope containing a DVD of Dirty Harry, but she is uninterested and gives it to Iain. He asks what is the matter with her, and Rosa thinks she knows.

Hanssen informs Ciaran that his contract will not be renewed.

Ciaran is called to Connie's office, where Hanssen explains that a member of staff in the department has been prescribing three times as many benzodiazepines as any of their colleagues. He asks Ciaran for an explanation; shocked, he maintains his innocence and puts the blame on Connie. Hanssen informs him that human resources will be in touch, and the hospital will not be renewing his contract. Ciaran asks Connie if she is happy now and reminds her that she is still the one with an addiction, but she feigns ignorance. He loudly accuses her of setting him up, but she closes her door in his face.

Outside the hospital, Iain expresses his appreciation to Gem for putting her life on hold for him and transfers £240 to her bank account so she can go to Thailand. However, she asks him if he knows how it feels to receive a call from a stranger informing her that he has "done something stupid again", but he tells her he wants to stop her making herself miserable for his sake. He agrees to pay for a subscription to an online streaming service so they can watch films together and gives her his suitcase, and she jumps for joy, exclaiming that she is going to Thailand.

In the staff room, Ciaran insists to Archie that Connie framed him, but she reminds him that he made the mistake of becoming too fixated on her. He acknowledges his mishandling of the situation and apologises, but he maintains that he is not the one who should be leaving and urges Archie to promise him that she will not let what happened go. After telling her that "it's on [her] now", he groans and leaves the department.

Day two

In her office, Connie notices that her diazepam packet is empty, so she writes herself a prescription. In a corridor, Archie expresses her despair to Will about Connie framing Ciaran, and she decides to go public with her knowledge. Will asserts that she is being "ridiculous", but she urges him to consider what Connie has been doing to patients and to Duffy, and urges him to back her up. He suggests speaking to Connie first and getting her side of the story; she asks him if he will support her if she is not happy, but he does not answer.

In their house, Duffy complains about not having anything to do at home, and Charlie suggests going shopping. He reminds her that "there's a difference between relaxing and rattling around", but she takes issue with his statement and asserts that it was not her choice to give up work; she quickly apologises. He gives her her car keys and kisses her before leaving for work. Outside her office, Archie confronts Connie, but she claims that she is busy. On her way out of the department, Dylan informs Connie that Serena Campbell wants to review the ED's controlled drugs policy, and she tells him that she needs to "run an errand". Despite Will's look of disapproval, Archie follows Connie out of the department and insists on speaking to her, but she claims that she is late for a meeting with the Trust; Archie is not convinced.

Duffy tries to help Shanti.

In a multistorey car park, as Duffy gets into her car, a girl named Shanti spots her and hides nearby. When she reverses out of her parking space, she runs behind the car and is knocked to the ground. Duffy rushes to her aid, but Shanti claims that she has a broken arm. Duffy insists on having her injury seen to and offers to drive her to Holby ED. Meanwhile, Archie watches Connie from her car as she enters Cousins' Pharmacy. Connie announces her presence to the chemist, Kostas Anatoly, but he asserts that they are closed; she points out that she has visited him late at night and early in the morning before. He informs her that it is "not a good time" and asks her to return later, but she maintains that she needs her prescription filled. He obliges, but he requests that she turn the sign on the door to 'closed', claiming that a stocktake is being carried out. She asks if there is a problem, but he assures her that there is not. Connie becomes suspicious when she spots the boxes of oral methadone Kostas has left on the counter; unbeknownst to her, he is being held at knifepoint by a woman.

Back at the ED, Noel informs Charlie that a young girl has come into reception following an RTC, and Duffy was the driver. In the waiting area, Shanti suggests that she and Duffy exchange insurance details, but Duffy points out that she was not in a vehicle. Charlie finds the pair, and Duffy assures him that it was "just a little scrape". Robyn arrives to triage Shanti, and Duffy promises to find Charlie later. Back at the pharmacy, Kostas gives Connie the diazepam and tells her to go, but Archie enters and confronts her. Connie insists on having their conversation outside, but Archie does not budge and proceeds to call the police. Suddenly, the woman threatens Kostas with her knife and demands that the police is not involved.

Robyn escorts Shanti out of triage and claims that she felt no bone tenderness, meaning that her arm is not fractured, but Shanti demands to be reassessed by a doctor. Charlie assures her that Robyn is "the best", but Duffy humours her request and asks Will to take Shanti for an X-ray; she subsequently asks Noel to do her a favour. At the pharmacy, the woman orders Kostas to put the money in the till in her bag with the methadone. Connie asks her what her plan is, but Archie interrupts and asserts that Kostas has pressed the panic button; she disagrees and claims that the "last thing he wants is the police swarming round". As he rushes to retrieve the safe, the woman spots Archie attempting to dial '999' and rushes her and Connie with the knife. Frightened, Connie tells her that she is a doctor and offers to treat her fever and infected track marks. She agrees, and Connie instructs Kostas to retrieve 500 milligrams of flucloxacillin; Connie is taken aback when she thanks her using her name.

In the staff room, Charlie points out to Duffy that Shanti has no injuries that are consistent with those from an impact and suggests that she is faking them. When he posits that, as she has had a "stressful" morning, she may not be able to see the forest for the trees, she insists that she has not forgotten how to drive and accuses him of treating her "like some fragile little thing that needs her hand holding". He claims that he does not want her taken advantage of, and she asks him if, before the dementia diagnosis, he would have given her the benefit of the doubt "as a functioning, intelligent adult". Will enters to make himself a drink, and Duffy tells him to get back to treating Shanti, asserting that she is "a victim".

Archie refuses to be treated by Connie.

As Connie inspects her track marks, the woman introduces herself as Michelle Gibson - a girl who used to babysit for Grace. She apprises her of her addiction to heroin, and she claims that, whilst she was using methadone to fight it, she became addicted to it as well. As Connie points out that that should not have happened, Kostas throws Michelle the bag and demands her to leave. She picks up the bag and accuses him of selling her excessive doses of methadone, prompting Kostas to angrily declare her a "liar" and attack her with a baseball bat. In self-defence, Michelle slashes his arm with her knife, and Archie wrestles her to the ground; in the corner, Connie suffers a panic attack. She assesses Michelle's and Kostas' injuries and instructs Archie to call for an ambulance, but she is horrified to discover that she has been stabbed in the abdomen. Michelle apologises profusely, and Connie orders her to retrieve the first-aid kit, but, fearing that she will be caught by the police, she makes a quick escape. Connie collects the kit and applies pressure to Archie's wound, but she demands to know how many diazepam tablets she has taken. After he fails to call for an ambulance, Connie begs him, and he reluctantly obliges. Archie is adamant on not being treated by her and tells Connie that she dreamed of working with her. When Archie struggles to breathe, Connie instructs Kostas to put the phone down and fetch a large bore needle. Connie desperately tries to insert a cannula into her arm, but Archie resists and scratches her; she pleads her to let her help.

In cubicles, Duffy asks Will if he has reviewed Shanti's X-ray, but he insists that she does not require on and asserts that she is a "chancer" who is potentially taking advantage of her dementia. Duffy argues that her condition is not obvious without prior knowledge, and she does not need neither him nor Charlie "protecting" her. Noel arrives and hands Duffy a poster from 2017 declaring Shanti to be missing. She shows Charlie and Will the poster and reveals that she was aware of Shanti's scam from the start and that she did not disclose the details of her disappearance as they would have been obliged to inform the police. Back at the pharmacy, Archie continues to resist treatment and claims that she does not trust her. Once she falls unconscious, Connie decompresses her tension pneumothorax. Once Iain and Ruby arrive and take over Archie's treatment, Connie goes to collect her box of diazepam, but Jan approaches her and asks if she is alright. She instructs her to pre-alert the hospital and insists on leading Archie's care.

Archie is taken into resus, and Will bursts in and demands Connie tell her what she did to her. She insists that she was stabbed whilst saving another person from attack and orders him to "get out". Charlie notices the scratch on Connie's arm and offers to treat it, but she decides to do it herself. In resus 2, she self-medicates and experiences a panic attack. Meanwhile, Duffy offers Shanti a drink, and she asks her why she left the department. She admits that she made a mistake which nearly killed a woman and that she has dementia. However, when Duffy asks her why she left and shows her the poster, Shanti panics and runs away. Duffy pursues her and asserts that she is "hurting", but Shanti admits that she was trying to scam her. Duffy tells her that she already knows and claims that nobody would benefit from her ending up in a prison cell or back on the streets. Shanti maintains that she has no idea why she ran away from home, but Duffy tells her that, since her diagnosis, people have been talking "at" her and suggests that they have a "proper" conversation.

Connie returns to resus, and Dylan informs her that Archie is presenting with symptoms consistent with those of a cardiac tamponade. When she is informed that the cardiothoracic team is still in theatre, she instructs the team to prepare for intubation and asks Charlie to contact Archie's next of kin. In the relatives room, Duffy gives Shanti a sandwich and a bottle of water. Shanti asks her what she likes to do when she is not "hanging 'round [the ED] or in car parks", and Duffy claims that she needs to pick up a hobby. Shanti gives her a LEGO brick from one of the sets she used to build at home and maintains that she cannot return there. When she starts asking if she only gets one life, Duffy assures her that people "rebuild".

Connie admits to not labelling the syringes and losing Duffy her job and dignity.

In resus, while Connie attempts to treat Archie's cardiac tamponade, she begins to hear her voice in her head and break down. Charlie moves her away from Archie, and she stumbles out of the room. In the toilets, she vomits and cleans the blood she unintentionally smeared on her face. By reception, Shanti claims that she will get by, and Duffy gives her the details of several local women's shelters. Shanti thanks and hugs her, and she tells her that she "must have been a really good nurse". As Connie goes back to resus, Iain and Ruby arrive with an unresponsive Michelle and press her for instructions. As Will leads her treatment in resus 2, Charlie finds Connie sobbing and gently escorts her to his office. She asks him how Archie is, and he informs her that she will be taken up to theatre soon. He tries to assure her that she is just "shaken up from what happened" earlier, but she claims that he does not know the full story. He asks her to elaborate, and she explains that, since her attack, she has been reminded of it every time she walks into the ED. When she asserts that Archie "found out" and should not have been at the pharmacy, Charlie struggles to understand. She admits to suffering from an addiction and hands him the diazepam from the pharmacy. Charlie realises that Ciaran was not responsible for the department's over-prescription of benzodiazepines. When she takes responsibility for the intubation incident involving Kat Hollis and the lidocaine mix-up that resulted in Duffy losing her job and dignity, an irate Charlie leaves her and goes to the staff room. There, Duffy finds him and asks how Archie and Connie are. He informs her that he will need to stay on, and Duffy understands, claiming that Connie needs him with her. She tells him that having someone come to her for advice has made her realise that she does not need to be a nurse to be there for people. She thanks him for helping her through her struggle and kisses him before leaving for home.

On ITU, Connie visits Archie and, while acknowledging that she has done "terrible things", she claims that she never meant for "this" to happen. Will appears and demands to know what happened; he informs her that she may not survive. Connie asks him how Michelle is, and she is saddened to learn that she has died of a methadone overdose. Distraught, she leaves, and Will sits by Archie's bedside. Connie returns to the ED, and Noel asks Charlie if she is okay; he tells him to get her coat and bag. He subsequently leads her out of the building. Elsewhere, a harrowed Will blames himself for Archie's stabbing and tells her that she is "so strong" and "much braver than [he'll]] ever be".

In the peace garden, Connie asks Charlie if he has spoken to Duffy, and he claims that she is "only just getting back on her feet". She promises to write a letter absolving her of any responsibility for the lidocaine incident so she could possibly return to work, but he points out that Duffy has given most of her adult life to the NHS and was not allowed to depart "with a little bit of dignity". Connie offers to resign, but Charlie accuses her of stealing Duffy's chance to resign and tells her that, while she should not be ashamed of her addiction, she should be ashamed of her lies. Devastated, he tells Connie to "go" and leaves her alone on the bench. She tries to stop him, but she stops herself and leaves the hospital grounds.





On 30 July, the BBC released a synopsis for the episode. The following day, it was confirmed that, as a result of the postponement of episode 42, episodes 46 and 47 would be shown as a single, feature-length episode. Its cast list was released on 1 August.

On 3 August, following the broadcast of episode 45, a 30-second trailer was posted on the official Casualty website and the show's social media accounts. Three days later, promotional images were released.

External links