On 21 November 2005, Jac - a locum registrar in general surgery - arrived on Holby City Hospital's Keller Ward to assist with performing a hemicorporectomy on Billy Finch, but Billy crashed his motorbike before undergoing surgery. Consultant Ric Griffin was forced to postpone the operation, and the multi-disciplinary team warned the surgeons that the hemicorporectomy would not be rescheduled due to its financial cost. Determined to allow the procedure to go ahead to impress her peers and secure a full-time placement at the hospital, Jac decided to break the rules and brought Billy's wife Melissa to the multi-disciplinary meeting. Swayed by Melissa's emotional appeal, the team decided to go ahead with the operation.
The next day, as fellow registrar Diane Lloyd was busy assisting on the Maternity Ward, Jac volunteered to assume her role in Billy's operation. Following the successful completion of the operation, Jac confronted Ric about her remaining on his surgical team full-time, but Ric declined. (HC: "Bird on a Wire")
Locuming on Keller
On 17 January 2006, due to a shortage of beds at St James' Hospital, Jac returned to Keller with a patient with ulcerative colitis named Leon. Given Leon's copious rectal bleeding and the risk of colonic perforation, Jac believed that a subtotal colectomy was his best option, but Diane was more inclined to respect his wish not risk having him fitted with an ileostomy bag for the sake of his marriage and proposed performing a rigid sigmoidoscopy to investigate further; Diane asked Ric for his opinion, and he concurred with her.
Following the sigmoidoscopy, Diane was confident that surgery was unnecessary, but Leon perforated his bowel and was rushed into theatre. In surgery, Diane was still determined to avoid resorting to an ileostomy bag, but Jac deemed the bowel untenable and told her to staple Leon's rectal sigmoid junction; Diane conceded and went with Jac's approach, leading to Leon's recovery. (HC: "Yesterday Once More")
On 24 January, Jac learned from medical student Matt Parker that there was a vacancy for a permanent job on Keller and decided to apply for it. On the ward, Jac and Matt treated a patient named Gerry who was complaining of abdominal pain, and his test results showed that he was suffering from lead poisoning. When Gerry's X-ray showed the presence of a foreign body, Jac and Matt found that Gerry had been shot in the buttocks while serving in the Territorial Army. Once the bullet was removed, Jac expressed her interest in the vacant registrar job to Ric who was already pleased with her mentoring of Matt. (HC: "Brother's Keeper")
First permanent shifts
By 2 February, Jac had convinced Ric to give her the full-time registrar job. In theatre, Ric informed Jac that there was a vacant consultant post, and Jac expressed a keen interest in applying. Later that day, when Diane was struggling to control a firefighter's internal bleeding, Jac suggested performing a partial hepatectomy. Diane insisted that they wait for a consultant to arrive, but Jac claimed that she was familiar with the procedure. Diane allowed Jac to take over, but Jac failed to locate the source of the bleed and admitted that she had only read about the procedure. Furious, Diane ordered her to step away from the table and managed to stop the bleed with clamps. Out of theatre, after Jac attempted to impress Ric by taking credit for the procedure, Diane decided to challenge her for the consultancy. (HC: "I'll Be Back")
On 20 February, Jac attended an interview of the consultant post and was confident that she impressed the panel, but fellow registrar Sam Strachan warned her the next day that Diane appeared to be the favoured candidate. While Jac was in the lift, it suddenly ground to a halt, and she noticed blood dripping onto her patient notes. Above, Jac found a man named Billy whose arm had been severed and promised to find and reattach it. Once they were freed from the lift, Billy was rushed into theatre and stabilised. After finding his arm, Jac proceeded to reattach it, but Ric asked her to allow Diane to take over due to her expertise in vascular surgery, leaving Jac feeling cheated.
After the surgery, Diane was concerned about the poor blood supply to Billy's arm, but Jac asserted that she was being pessimistic and insisted on waiting for signs of improvement. However, when Billy's wife Jane's condition suddenly deteriorated, Billy hit his arm while attempting to stand by her bedside and damaged it further. In theatre, Diane contended that the attachment was compromised, but Jac insisted on redoing the anastomosis; Billy soon became septic, and the arm was deemed unviable. However, as Diane took over the operation, Ric arrived, and Jac allowed Diane to take the blame for endangering Billy's life. In the locker room, Jac took responsibility for the incident and admitted to Ric that she just wanted to impress him. Jac expected to be fired, but she was surprised when Ric praised her tenacity and assured her that both she and Diane would make fine consultants. Outside the hospital, Jac was taken aback when Ric introduced Nick Jordan as Keller's new consultant general surgeon. (HC: "Out on a Limb")
Conflict with Nick Jordan
On 14 March, Ric asked Jac to keep him informed of Nick's activities on Keller while he was at St James', suspecting that he would take an interest in Carlo Cominetti, a patient scheduled for an aortic valve replacement on Darwin presenting with a duodenal ulcer. When Carlo began to suffer from peritonitis, Jac confronted Nick about his decision to operate on Darwin and suggested that he would rather be a cardiothoracic surgeon than a general surgeon. After learning that Carlo had previously undergone a laparotomy, Jac warned Nick of the risk of scar tissue being a hindrance and threatened to tell Ric if he did not properly inform Carlo of the risks.
In theatre, Carlo developed aortic stenosis, and Nick decided to put him on bypass. Frustrated, Jac brought in cardiothoracic surgeon Connie Beauchamp, but Connie was impressed by Nick's adaptability and allowed him to assist on the valve replacement. After the surgery, Jac accused Nick of setting up the situation in theatre to impress Connie and get back into cardiothoracics, and Nick threatened to disclose her inexperience in the procedure if she reported his behaviour to Ric. Once Ric returned, Jac told him that there was nothing to report about Nick. (HC: "Let It Shine")
On 30 March, as Jac and Nick performed a laparotomy on a patient named Philip, Jac suggested that there may have been some trauma to his oesophagus; Nick posited that the air in Philip's mediastinum may have been caused by something further up and decided to investigate without being cardiothoracics involved. Out of theatre, Jac criticised Nick's eagerness to attempt cardiothoracic procedures, but he reaffirmed his authority and told her to concentrate on refining her own skills. On the ward, Philip's condition began to worsen, so Jac decided to page someone from Darwin instead of Nick who was attending a cocktail party. Upon reviewing Philip's X-ray, registrar Joseph Byrne found a large tear to his tracheobronchial junction and rushed to Darwin for surgery.
Once Nick arrived in theatre, he berated Jac for not informing him of further complications to Philip's health and blamed her for the incident. Nick prepared to scrub up, but Connie reminded him that cardiothoracics was no longer his field. Afterwards, Nick informed Jac that Ric wanted to speak to her in the morning about her version of events. On Keller, Jac insisted that there was nothing more that she could have done for Philip, but Nick told her that Philip now required dialysis and a transplant due to the renal damage he sustained from hypoxia and hypotension. The following morning, Jac explained her actions to Ric, and Ric reminded her that she needed to confer with senior colleagues from her own department and work entirely off of facts. (HC: "Snake in the Grass")
On 5 December 2017, the team of new neurosurgeon and Director of Surgical Innovation John Gaskell asked Jac to assist with operating on Michael Ambrose, a man with a spindle cell tumour that was compressing his spinal cord. On the ward, Ollie confronted Jac about her decision to offload all of her procedures onto him, but she ultimately ordered him to stand down during an aortic valve replacement. Ollie challenged her, and she bluntly told him that he lacked the "mettle, the drive" and the "ability", and would never have "even the slightest chance of saving [his] pathetic excuse of a career" if he continued to oppose her.
Later, in her office, Ollie told Jac that he felt "empty" on Darwin and ordered her to acknowledge his resignation. Despite her efforts to discuss Michael's case and the potential pitfalls of Gaskell's trial, Ollie insisted that she owed him an apology and suggested that she was "terrified". Sacha later attempted to express his concerns about Gaskell's reluctance to share his research amongst the medical community, but Jac, overridden with anxiety, sat outside the Darwin theatre, where she was consoled by Fletch.
In theatre, Jac reluctantly proceeded to insert Michael's aortic graft, but she felt that she was unable to complete the procedure and walked out. In a confrontation with Gaskell, she accused him of being unethical and feeding off the uncertainty of his colleagues, but Gaskell insisted on having the likes of Hanssen witness his work and urged her to help him. Upon their return, as Gaskell attempted to insert the tissue scaffold, Michael's artery of Adamkiewicz became unclipped, forcing Jac, who was on the verge of tears, to plug it with a pledget. Once the bleed stopped, Jac ran out of the room and broke down in Fletch's arms.
Following a moment of clarity, Jac decided to leave Holby and apologised to Ollie, insisting that it was his duty to remain at the hospital and become the consultant he "should be". On the stairs, she bumped into Raf and asked him to hand Hanssen her letter of resignation. However, in the basement, Jac encountered Hanssen's son Fredrik who proceeded to shoot her in the back. (HC: "Group Animal - Part One") She was soon discovered by Sacha, Hanssen, Gaskell and Essie who rushed her into the wet laboratory.
Using breathing equipment from a teaching aid and chloroform as anaesthesia, Sacha reluctantly performed a thoracotomy on her and discovered that one of her major vessels had been injured. Gaskell proposed printing an experimental patch to stop the bleed, but Sacha vehemently disagreed and insisted on waiting for more equipment to arrive. However, with Hanssen having left to confront Fredrik, Sacha eventually allowed Gaskell to insert the matrix, and Jac's pulse soon returned. Once Fredrik was neutralised by armed police, and the hospital's lifts were reinstated, Jac was taken to ITU. (HC: "Group Animal - Part Two")
As the general surgical ward at St James' Hospital was being downsized, Jac was keen to impress Ric Griffin in order to acquire a permanent position on Holby City Hospital's newly-expanded Keller Ward (HC: "Bird on a Wire") and managed to convince him to give her the registrar job there. Her ambitions grew upon learning of a consultant general surgeon vacancy, and she began to take credit for her colleague's procedures after lying about having experience performing complex operations. (HC: "I'll Be Back") Fearing that fellow registrar Diane Lloyd was more likely to be given the job due to nepotism, Jac allowed Diane to take the blame for endangering a patient's life after reattaching an unviable arm. However, Jac felt guilty and eventually took responsibility for the incident. (HC: "Out on a Limb") Her sense of empathy also extended to recognising issues in her colleagues' private lives, as she realised that Ric possessed feelings for Diane and urged him to act on them before Nick Jordan could sully their relationship. (HC: "Honesty")
Jac viewed Ric as one of the greatest surgeons in his field and was eager to work with him full-time. Following the successful hemicorporectomy in November 2005, Jac approached him about remaining on his surgical team, but Ric initially declined. (HC: "Bird on a Wire") When Jac locumed on Keller again in January 2006, Jac impressed Ric with her diagnostic skills and mentoring abilities, (HC: "Brother's Keeper") and she successfully secured a permanent job at Holby City. (HC: "I'll Be Back") When a consultancy was made available, Jac tried to impress Ric by reattaching a patient's arm, but the injury later became septic and nearly killed the patient. Regardless, Ric admired Jac's tenacity and believed that she would make for a fine consultant. (HC: "Out on a Limb")
Upon Jac's return to Holby City in January 2006, she and Diane clashed over the treatment of a patient with ulcerative colitis, and, after Diane agreed to lie to the patient's spouse about his admission, Diane took umbrage when Jac suggested her judgement was being clouded by the recent breakdown of her marriage to Owen Davis. In a conversation with Ric, Diane branded Jac as "blunt", "abrasive" and "patronising", and said that she would not be happy with Jac locuming on Keller again. However, following Jac's success in theatre, Diane praised her surgical skills and claimed that she was pleased that Jac was Keller's locum. (HC: "Yesterday Once More")
After returning to work from weeks of research, Diane was surprised to hear that Jac had secured a permanent post on Keller, and she was irritated when Jac continued calling her "Di" despite being corrected numerous times. In theatre, when Diane struggled to control a patient's internal bleeding, Jac claimed that she could perform a partial hepatectomy and took over. However, Diane was furious when Jac admitted that she had only read about the procedure and managed to stop the bleeds herself. Out of theatre, after overhearing Jac take credit for the procedure, Diane decided to challenge her for the vacant consultant job. (HC: "I'll Be Back")
Feeling as though Diane had favoured status among the panel, Jac was determined to win Ric over by reattaching the arm of a man named Billy. Diane was not optimistic about the blood supply to the arm post-op, but Jac insisted on waiting for signs of improvement. Ultimately, Billy's arm became ischemic and was deemed unviable. As Diane took over the operation from Jac, Ric arrived and mistakenly reprimanded her for endangering Billy's life. Later, Jac admitted that she was responsible. In the end, the consultant job was awarded to an outside candidate - Nick Jordan. (HC: "Out on a Limb")
Sharing a history with Nick, Jac was unhappy to learn in February 2006 that he had been appointed as Keller's new consultant general surgeon (HC: "Out on a Limb") and suspicious of his change in specialities. (HC: "We Gave Her All Our Love") In March, Nick took a keen interest in a patient with a duodenal ulcer who was scheduled for an aortic valve replacement and decided to operate on Darwin, leading Jac to suspect that he was planning on getting back into cardiothoracic surgery. In theatre, Carlo's condition deteriorated, and Nick decided to put him on bypass. Frustrated and concerned about Carlo's wellbeing, Jac brought Connie Beauchamp to the table, but Connie was impressed by Nick's adaptability and allowed him to assist on the valve replacement. After surgery, Nick admitted that he wanted to return to cardiothoracics and threatened to report Jac for failing to disclose her lack of experience in Carlo's procedure if she informed Ric of his actions. (HC: "Let It Shine")
Later that month, Nick continued to show an interest in performing cardiothoracic procedures, and Jac confronted him, but he reasserted his authority and told her to focus on her own pitfalls. When their patient's condition deteriorated further, Jac, instead of consulting Nick, paged Joseph Byrne, a registrar on Darwin who rushed the patient to Darwin for surgery. Once Nick found out, he berated Jac for not informing him and blamed her for the patient's overlooked cardiac issues. (HC: "Snake in the Grass")
In April, following an unsuccessful small bowel transplant, Jac overheard Nick attempting to soil Ric's reputation in front of the patient and warned Ric. (HC: "Honesty") After Nick allowed Diane to take the blame for Helena Bosman's death, Jac viewed Nick as being disloyal and decided to assist locum consultant Percival "Abra" Durant out of spite. (HC: "Invasion") Later that month, Jac threatened to disclose the circumstances behind Nick's return to Holby to Lord Byrne to stop him securing the cardiothoracic consultant post at St Luke's Hospital, but Nick suggested that it was a "risky" move and attempted to entice her with the idea of a consultant vacancy on Keller. Regardless, Jac and Ric publicly stated that Nick was fired from St Damian's Hospital after a patient died from a faulty swab count. (HC: "The Truth Will Out") Nick later departed from the hospital after being offered the CT consultant post at St Luke's. (HC: "Extreme Measures")
Behind the scenes