This article is not part of the Holby universe.
This article covers a subject that is part of the real world, and thus should not be taken as a part of the Holby universe.







Episode 1140 of Casualty is the second episode of series 34 of the show. It was directed by Steve Brett and written by Rebecca Wojciechowski.

This episode sees the first appearance of Victor Oshin as junior doctor Mason Reede. His casting as the character was announced ten days prior. The episode also features Abigail Hardingham's first appearance as Effie Laurence, a young woman with cystic fibrosis.

Plot

In his room, Rash messages Gem and tells her that he cannot wait until she returns, but she points out that it is six o'clock in the morning and asks him if he is okay. He goes to respond, but he hears something falling on the floor downstairs. He finds Ashok picking Madia's belongings off the floor and reminds him of his agreement to have a bath and get some sleep. Rash asks him if he wants him to delay his return to work, and he nods.

At the ED, in the consultants' office, Ethan wakes up from a nightmare, and Marty informs him that his request to cover the follow-up clinic was firmly turned down by the manager; he urges him to go home. Meanwhile, Charlie is surprised to find Duffy cheerfully folding clothes and towels, and she explains that keeping her mind active is making her feel like herself again. He tells her that the large envelope he is holding may contain the power-of-attorney forms and suggests filling them out once he returns to work, but she claims that she will go through it while he is at work.

Outside the department, Rash informs Dylan that he needs to delay his return to work as his father is not coping, and Dylan assures him that they will find cover for him. However, a mother named Hollie approaches him and claims that her infant daughter Evie Sumner has a bad cold. Rash directs her to triage, but she insists that she is "not the type to worry for no reason". Nearby, a woman named Effie asks her father Theo why they are parked at a hospital, and he asserts that he needs to speak to an old friend.

Mason introduces himself to Ethan.

In the staff room, Will recommends that Ethan attend a fundraising event at The Hope & Anchor during the evening for the victims of the market attack, but he declines. Robyn introduces Ethan to his new mentee - F1 Mason Reede. Mason claims that it is an "honour" and wishes that he could have started a week earlier during the terrorist attack. Ethan decides to oversee him, but Will orders him to go home. However, Jacob informs him that a friend of his from university wants to see him. In a cubicle, Rash assesses Evie's condition and believes that she is suffering from a viral infection. He goes to ask Hollie if she has taken her temperature, but she hands him a sheet of paper detailing her symptoms, explaining that, as an air-traffic controller, she insists on converging "around data, not assumption". He asks if there is anyone that they should call for her, but she informs him that her husband died whilst she was pregnant. As Rash detects signs of intercostal recession, Robyn dumps Mason with him. Charlie apprises Rash of Evie's obs, and he quickly decides to take her to resus. He alerts Dylan who leads her treatment and asks for Will to be paged. Mason suggests that Evie may have sepsis, but Dylan claims that they were all already aware.

Ethan and Theo greet each other outside cubicles, and Ethan asks Theo why he has come to speak to him. He explains that he has heard that the hospital is about to start a cystic fibrosis trial and asks if he has any connections with those involved so he could potentially get Effie onto it, but he is disappointed to learn that it is not within Ethan's remit. Nevertheless, he offers to speak to Effie and encourage her not to give up hope. Outside, Theo reintroduces Ethan to Effie, but she asks him what is actually transpiring; he admits that there is no open day. Stunned by his dishonesty, she walks away and is nearly hit by an ambulance. Theo admonishes her for her disregard towards her own health and claims that he is aware that she went out drinking the night before, but Ethan tries to deescalate the situation and offers to check her over inside. She asserts that her life is "one big check-up", but Theo convinces her to humour him.

As Dylan administers the third bolus and asks for PICU to be called, Rash assures Hollie that Evie is in the right place. However, her chest X-ray shows the presence of a large fluid collection around the left lung, suggesting that it is an empyema that requires draining, and her sats begin to drop. Once she has been intubated, Dylan calls PICU and informs them that Evie has not been responding to fluids or inotropic support; she urgently requires a bed on the ward. As Will arrives, Rash tells Hollie that the best thing she can do is being there for her daughter, but she asserts that she cannot make good decisions if she does not know what is happening and urges him to promise her that he will tell her everything. He warns her that her condition is serious, but Charlie reassures her that they are "a long way" from thinking that she will never come home with her. Rash quietly tells Mason that it is okay to feel "a little out of [his] depth", but he asks why he would feel that way.

In cubicles, Theo asks Ethan if Effie could be given a separate room, fearing that she may be vulnerable to "germs", but he assures him that the department is clean. He decides to perform a lung function test and asks when she last underwent one; he is told that she had one two weeks prior. Theo is hopeful that, if she remains in relatively good health, she could potentially be a candidate for a drugs trial; she flippantly asks Ethan if her father was "this annoying" at university. Theo is unimpressed, but she asserts that she is hung-over and indignant at being brought to the department under false pretences. He apologises and admits that he is just worried about her, and she understands. However, as Ethan prepares to test her lung function, she asks her father to buy her food. Once Theo leaves, she asks Ethan to tell him that she just needs to keep up with her health regime, and she reveals that her condition has been worsening for months, and her lungs are failing.

In resus 2, Mason assures Hollie that "everything is going to be okay", but Rash stares at him in disapprobation. Will informs her that Evie has not been responding to their treatment as they have hoped, and she will be transferred to PICU to have her empyema drained. She asks if she will be alright following the procedure, and Dylan claims that they will try their best. The team prepare to move Evie to PICU, and Dylan suggests that Rash returns to his father, but he insists on staying. Meanwhile, Ethan stresses to Effie that he cannot lie to Theo about her health and asks her what her doctors deduced. She claims that her lung function is down to 20%, and the physicians discussed her receiving a transplant. Ethan offers his condolences, but she tells him that he does not need to make her father even more stressed. Ethan suggests that she could get onto a trial, but she contends that she is too sick and has accepted her fate, unlike Theo who is still struggling after the loss of his wife. He soon returns with a sandwich, and Effie asserts that her lung function is stable. He asks Ethan for his opinion, and he advises that she keeps on top of her health regime. Believing that Effie is still on course for a trial, he hugs Ethan in relief.

Duffy struggles as she fills out the power-of-attorney forms.

The resus team carefully moves Evie to the lift, but her heart rate begins to slow down. When the heart monitor starts beeping rapidly, she is taken back to resus; confused and scared, Hollie repeatedly demands to know what is transpiring. Charlie receives a call from Duffy on his phone, but he is forced to decline it. At their home, Duffy sighs and proceeds to fill out the power-of-attorney forms, but she struggles when she reads through a section pertaining to mental capacity. Back in resus, a petrified Hollie suggests that Evie's condition could be linked to her late husband's heart problems, but she is ignored. As Dylan suggests that they may be in an "irretrievable situation" if she loses all output, he detects a pulse.

While Effie prepares to leave, Theo asks Ethan to speak to a cystic fibrosis specialist if he gets the chance. He accedes, but he warns Theo that trials are "an unknown", and they cannot be relied upon. Effie urges her father to let Ethan go home, and Theo apologises and bids him farewell. However, Ethan stops them and offers to take Effie for a chest X-ray. Theo accepts the offer, and Effie acquiesces. In admin, Dylan calls PICU and suggests that, given Evie's grave condition, she needs an "appropriate space". Rash recommends that Mason take a break, but he asserts that he is ready for "whatever comes through those doors". Jacob informs Rash that Ashok wants to see him, but Rash insists on helping Hollie. Jacob points out that he appears distressed, and Rash reluctantly decides to meet him.

In cubicles, Ethan claims that he felt very uncomfortable misleading Theo, but Effie asserts that he would have a nervous breakdown if he learns about her condition and asks whose benefit is the X-ray for. Ethan insists that he needs to be aware of the full extent of her illness if he is to be complicit in her deception, but she is not interested and leaves. In resus, Dylan informs Hollie that Evie's organs are beginning to shut down as a result of her infection, and she is finally being transferred to PICU where she will be more "peaceful". Charlie asks Hollie if she will accompany her daughter upstairs, and she tells him that Evie enjoys having her hand tickled. Dylan instructs Rash and Mason to keep an eye on Hollie until she decides to go to PICU.

Outside the department, Ethan pursues Effie and castigates her for not taking her health seriously. He asks her if she realises how many innocent people die randomly, but he retracts his question and apologises. She asserts that he needs a drink as much as she does and, despite his objections, goes to The Hope & Anchor. In resus, Rash asks Hollie if there is anybody who should be there to say goodbye to Evie, and she reminds him that her husband Pete is dead. She hypothesises that, despite their cardiothoracic consultant assuring them that it was not hereditary, Evie has the same heart condition as Pete, but Rash informs her that Evie's illness is a result of an unrelated case of sepsis. Hollie wishes that her husband was there, and Rash assures her that he can be with her and Evie "in a way" and asks her what Pete would do to make her death a "special" time for her. However, he notices Ashok speaking with Mason outside and leaves her alone. He confronts his father and asserts that he cannot be at the department, but Ashok reminds him of his promise to return home. Rash asks Mason to keep an eye on Hollie and takes Ashok elsewhere. He berates his father for appearing at his workplace and contends that he can go through Madia's belongings on his own, but Ashok asserts that they could sort through them together. Rash promises that he will be home tomorrow and assures him that they will be okay, and Ashok apologises and encourages him to return to his case.

Ethan opens up about his feelings following the market attack.

Back in resus, Mason waits for Rash to return and asks Hollie if she can get her some water, but he notices that her top is soaked in breastmilk and offers her paper towels. She asks where Evie is and runs out of the room in a panic. Robyn tells her that she is about to take her belongings to her upstairs, and Hollie decides to do it herself. Robyn gives her a fleece and offers to find her some pads, but Hollie spots the state of her top and runs away; Rash volunteers to follow her. At the pub, Effie claims that she is bored of thinking about Theo's lie about there being a university open day and asks Ethan how he is. He claims to have had a "difficult" week that has "raked some stuff up", and he reveals that he was present at the market attack; he asserts that he finds the senselessness of the act "strange", and he does not feel "very proud of being a Homo sapien". She asks him what memories the attack "raked up", and he states that there are old feelings about someone who was close to him who died suddenly; she offers her sympathies and assures him that feeling unsettled is alright. Ethan mentions Theo not fully accepting that she is an adult, and she posits that, if she is going to end up dead in a few years, it just means that she is free, and she insists that she will not die how her mother did. As Ethan suggests that they "work on [Theo] together", Effie begins to cough up blood.

Nearby, Rash warns Hollie that Evie's chances of survival are very slim, but she demands that the medical staff do not give up on her and accuses them of lying about her condition. He tells her that he does not want her to have false hope, and he suggests that, one day, she might find peace in the fact that she had the chance to say goodbye to Evie. She asks him what she should do, and he recommends doing what she believes Evie needs her to do for her. In resus 3, Ethan asks Marty to call the respiratory ward about Effie as Theo rushes in. The ward asks for her medical history, and Theo claims that Effie's lung function is just below 40%, but Ethan corrects him and states that her lung function is actually hovering around 20%, and she has been advised that she may require a transplant. Meanwhile, Rash escorts Hollie to PICU, and Charlie informs her that Evie's organs are shutting down, and the medical staff will monitor her for a while before they remove the ventilator. She asks if it will hurt her, and he assures her that it will not. She decides to make Evie more comfortable first by asking for her blanket, and Charlie tells her that he never left her side. Outside, he checks his phone and finds that he has missed five calls from Duffy.

In the consultants' office, Ethan writes up Effie's notes, but Theo knocks on the door. Ethan tries to assure him that she could live for many more years if she keeps on top of her health, but he demands him to stop talking to him like a doctor and begins to despair. Ethan explains that Effie hides information from him because she does not want him to worry about her, and, when Theo asks him if her coughing up blood will make her ineligible for a cystic fibrosis trial, he claims that he does not know. On PICU, Rash suggests that Hollie should tell Evie everything she wants her to know to make up for her mistake with Pete. She tells her that her father fought hard to have the chance to meet her, and she loves her "so, so much".

Ethan visits Dylan in his office and claims that a friend of his who is a general practitioner wants to know the criteria for the hospital's cystic fibrosis drugs trial; he is not sure if it would accept patients with sub-40% lung function and immediately dismisses the chance of a sufferer with a history of haemoptysis being selected. Meanwhile, Charlie returns home to find a forlorn Duffy sitting on the stairs. She apologises for constantly calling him and expresses her fear of "[losing] her mind"; Charlie assures her that she will not be on her own. She asserts that she needs to keep her mind active while she still can, and she needs to get a job. Charlie embraces her and tells her that he loves her. In the staff room, Mason tells Rash that he felt as though he could not get anything right, but Rash reminds him that he is only at the ED to learn. Mason asks if he will get into trouble for allowing Hollie to leave resus, and Rash assures him that he will explain what happened to Dylan and tells him that, as junior doctors, they need to look out for each other. However, as he receives a text from Gem, Dylan calls Rash into his office; Mason has informed that Rash left him alone with Hollie. Rash insists that he was only gone for a "couple of minutes", but Mason asserts that he was actually left alone for half an hour and goes on to suggest that Rash was not focused on treating patients. Dylan reminds Rash that he always had the opportunity to leave, and Rash reluctantly apologises.

Rash shares a hug with his father.

In HDC, Ethan explains to Effie that, while her bleeding has settled, she will need to be put on a course of antibiotics. Theo requests for more up-to-date information about her care routine, but she insists on going home. However, Ethan informs her that she will need to be admitted and kept in overnight. As he leaves, he vows to get her onto the trial. Rash returns home with dinner, but he is surprised to find that Ashok has cooked two frozen pizzas for them. He also presents Rash with a bike that he had bought for him with the remainder of the state pension. Rash insists that it is too much and that the bus is "fine", but Ashok asks if "fine" is good enough for "her great son, the doctor". Rash thanks him and asks if they will be okay. Ashok maintains that they will, and they share a hug. Back at the ED, Will asks Ethan if he wants to attend the fundraiser at The Hope & Anchor, and Ethan agrees to follow him down. Alone, he edits Effie's records and omits all references to her haemoptysis.

Cast

Uncredited

Trivia

  • The news ticker during Dylan Keogh's interview mentions a story about a multi-vehicle crash on a dual carriageway involving an ambulance. This is likely a production error, as this exact headline previously appeared at the beginning of series 33, episode 2 following the incident that killed paramedic Sam Nicholls.
  • The dream sequence is a reference to a scene in a film named Film Club.

External links

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