Karen Claymore and her young son Jake have been in a car crash and even though Jake’s punctured lung can be fixed, Karen has severe internal bleeds and tests confirm her brain dead. Tom realises this is a brilliant chance to get a heart transplant to Billy Sanders, a young boy suffering from DCM, cardiomyopathy, and whose heart now has enlarged so much that he has been diagnosed with end stage heart failure. Karen’s mother Pam Singer, who did not meet her daughter for years, until recently, is not sure about Karen’s wishes, but her husband Pete gets her convinced that this is Karen’s chance to do something good in life and save someone’s life. Together with Tom he gets her to sign the consent form, even though they run into a bit of a problem when Billy’s mother suddenly does not want to accept the heart, having found out that it has got a little hole in it that, however, will be fixed before him getting it. When Billy goes into brachycardia she eventually realises that he does not stand a chance unless they accept the transplant and they agree to go forward.
While preparing for surgery Pam suddenly changes her mind and asks Tom to stop the transplant, so that Jake can get a chance to see Karen while she still is breathing, thinking that will make it easier for Jake to understand what has happened to his mother. Tom mentions that the papers have been faxed and it might be too late, but promises to do anything he can. Spurred by the recent death of a transplant patient, Tom decides to take a risk to save Billy’s life and goes ahead with the operation even if Pam has withdrawn consent, faxing the papers to the transplant coordinator straight after talking to her. He makes sure they quickly get into theatre before anything can be done to stop the transplant and it is successful. After surgery Zubin finds out about Tom’s actions and is furious that he has been duped into carrying the can for Tom by countersigning the consent form. He thinks Tom is out of line and is left to pick up the pieces. Tom resolves that his duty to the health of a living patient overrides his adherence to hospital procedures.
Meanwhile, Ric is feeling good about himself but is despondent when Karen subsequently dies. Zubin notices Ric’s changeable moods and persuades him to see a specialist, suggesting that he should meet Jed Allenson, one of the psychiatrists. Reluctantly, Ric faces his demons and confesses his gambling addiction is taking over. He feels as if everything is spiralling out of control and he cannot stop it. He explains how he has gambled his marriage and was never happier than when he lost and how he once gambled with himself, trying to check if he could operate on a young patient using his left hand. In order to regain some level of control, he even warns Jess not to go to Nic’s funeral, in case the Press get wind of it, but she decides to go anyway and Ric finally, after having had his little chat with Jed, admits that she should go if she wants to. Jess also has to clean out Nic’s locker and finds it harder than she thought.
Louise O’Connor has been beaten up at work at her and her brother Shaun’s car hire firm. She has got internal injuries, but is reluctantly to go to surgery, because of having a rare blood group and having had a bad reaction to blood when she was younger. Her injuries, however, require surgery and they try to avoid a blood transfusion as long as they can, but in the end it is not possible. An internal bleed and a reaction to the transfused blood almost kill her on the operating table, but luckily Ric can save her, even though she ends up with renal problems. After waking up she finds out that she was not being robbed, but that Shaun instead knows who did it to her – some people who were not pleased about his efforts to takes his business into new areas.
Karen Claymore, dies after an internal bleed she got in a car crash
Jake Claymore, Karen’s 6-year-old son, punctured lung
Louise O’Connor, beaten up, rare blood group causes trouble
Billy Sanders, a young boy suffering from DCM, has end stage heart failure and needs a heart transplant
Zubin: You fly today.
Ric: You ought to keep up.
Zubin: It’s like being back to school. Last one there gets his head flushed down the toilet.
Ric: What school did you go to? I haven’t been gambling a week, I haven’t felt so positive in ages.
Zubin: How’s counseling for you?
Ric: Actually I didn’t go. Counseling’s just not my thing though. It is too formal.
Pam Singer: Jake, I need to talk to you about your mum. The car accident hurt her much more than any of us realised. And unlike you, she didn’t wake up. She died, do you understand what that means?
Pam Singer: But I’m going to look after you, if that’s okay.
Tom: Mrs Singer, as soon Karen’s ready to be seen, I’d like to take you and Jake up there.
Pam Singer: That would be fine.