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Cas Character

Toby De Silva

Played by Matthew Needham


S22 E1 ‘My First Day (P1)’ – S23 E19 ‘My Last Day (P2)’

Job Title

F2 Doctor

First Words

(to passer-by) Excuse me, is this the bus stop for the Holby hospital?


Toby is one of two new F2 doctors, joining Holby ED at the beginning of Series 22. He’s very young and nervous when he joins, but can also be funny and self-deprecating. Toby lacks confidence, and as an only child always felt a lot of pressure from his highly successful parents, who are both in the medical profession. Having just scraped through med school, he’s now scared of being a doctor and the huge responsibility it brings. With hard work though, Toby could become a much better doctor than he imagines. Toby has a lot to learn, but most of all needs to become more self-confident.

S22 E1 focuses mainly on the character of Toby as he goes through his first day in the ED department. While other F2 doctor Ruth oozes confidence poor Toby manages to screw up nearly every job he’s given, including letting overdose victim go without treatment. A despairing Maggie sends Toby out with Dixie where they witness an almighty explosion. The pair run to assess the damage; Toby tries to suppress his horror at the carnage facing him and begins to assess the victims. When the medical teams arrive Toby is forced to help Maggie amputate a young man’s arm in order to rescue his mother trapped beneath the debris. Alone again Toby finds a little girl, Rayne, trapped in another part of the collapsed shops. He carries her out but is immediately confronted by her distraught father, who takes the little girl and runs, ignoring Toby’s pleas to reunite the girl with her injured mother. Toby takes Charlie’s car and drives off in search of Rayne. He cannot find her but instead spots Sunny. He is determined not to let Sunny go again and begs him to return to the ED for treatment. Sunny fights Toby off and runs. Toby returns to Charlie’s car to find it wrecked. Back in the ED, Toby finds himself in the midst of the majax crisis but he struggles to be helpful. When an MI patient dies in his care – Toby can’t cope any more and leaves. Even meeting Sunny who has finally come in to be treated doesn’t change his mind and Toby walks away, feeling lighter with every step. That is until he spots a clearly very ill Rayne with her father. Toby takes her from him and realises the little girl is diabetic. He runs with her to a chemist and immediately gives her an IV injection of dextrose, saving her life. When the ambulance arrives to take Rayne in Dixie offers Toby a ride back. Toby realises he is a doctor after all and climbs into the back of the ambulance. In S22 E5 Toby experiences the first death in his care. An elderly lady, Romaine, has chest pains. Toby takes the lead in Romaine’s treatment, and gets close to the her as she deliriously declares the train driver to be her long-lost son. The driver insists they aren’t related, but sits with her so she isn’t alone. When she dies, Toby is devastated. In S22 E8, [ID 2024]Adam[/ID] tries to teach Toby the basics of intubation on a dead body, having been disappointed when Toby failed to intubate a patient in an emergency situation. He decides to take the young doctor under his wing to give him the expertise he desperately needs. He commandeers a dead body and sets about his unorthodox training methods. In S22 E10, Toby watches Adam deliver bad news to a patient’s family, but, unable to cope with the tension, Toby laughs at the worst moment. Exasperated, Adam sends Toby out on a paramedic shift where he can’t upset anyone else. In S22 E11, a patient is being abusive and aggressive and Toby needs to sedate him. For once, Toby stands up to his patient but he responds by punching him to the ground. In S22 E13, Toby enlists Big Mac’s help in clearing his name of being the Toxic Shark blogger – fed up at the accusations from both Harry and Adam. In S22 E14, Ruth is excited about the lecture to be given by Professor Camille Windsor on trauma surgery. She tells Toby that he should stay on the floor, while she goes – which he’s more than happy to do. Following the lecture, Camille observes in the ED. Toby messes up, but Maggie tells him he shouldn’t be concerned what Camille or anyone else thinks of him. Toby reveals the reason he is so concerned is because Camille is his mother. With his confidence at rock bottom, and questioning his motivation to work in medicine, he decides to resign. Next episode he writes his letter of resignation while in the on-call room at Holby ED. His confidence is at rock bottom and he’s doubting his vocation. In S22 E15, Ruth is about to treat a man with a severely injured foot when Adam instructs Toby to take over. Ruth feels isolated and alone, while Toby copes well with the difficult procedure and decides not to resign. In S22 E16, Ruth and Toby innocently wake up in the on-call room together, which doesn’t go unnoticed by Kelsey. She gossips about it within the department, and Maggie hears. She quizzes Toby, and, discovering that he has moved out of his mother’s house, offers him a room. Toby asks whether she also has a spare room for Ruth, but she doesn’t. In S22 E24, Toby and Abs decide it’s time Ruth lets her hair down after she goes home following a tough shift alone. They go round to see her but are shocked to discover her hanging in her room. In S22 E26, Toby has pulled a sickie and goes to the pub with Maggie’s pregnant daughter Joanne. It’s an escape from the pressures of the ED. Maggie, Tess and Harry are all concerned that Toby has lost his confidence since Ruth’s suicide attempt. While there however, she goes into labour and Toby is forced to help assist her labour. In S22 E27, it’s Toby’s first day back, he looks apprehensive as he arrives. Maggie is talking about Ruth and saying how she’ll pull through. She suggests Toby go up and see her, but he doesn’t. Marilyn approaches Toby, to welcome him back. She tells him Ruth’s orthopaedic surgical rotation is available and that he should apply to do it. In S22 E28, Toby visits Ruth for the first time since she’s been in ITU. He spots her diary and can’t resist reading it aloud, but he gets angry when he reads what she thought of him. As Ruth opens an eye and pulls her hand away from Toby’s, he realises that she’s coming out of her coma. In S22 E31, Toby takes offence when Maggie goes over his head to stop him leaving the department. In S22 E32, it’s Toby’s first day on his orthopaedic rotation, which he’s nervous about and, unbeknown to him, Maggie has concerns about his ability. Consultant Sean discusses the implications of Toby’s nervousness with him and reveals that Maggie doubted him. In S22 E36, Toby gets an ear-bashing from Sean, but later receives a kiss from Joanne, leaving him on cloud nine. Next episode he has spent the night with Joanne, but is late for his night shift as he lingers to say goodbye to her. In S22 E41, Toby, meanwhile, has asked Maggie out to dinner, to say thanks for all her help and support. She’s been looking forward to it, and has had to turn down one of Charlie’s subtle advances. At the end of the day, though, she makes a shocking discovery – she finds Toby and Joanne in bed together. In S22 E43, Toby, starts the day on a high. He has flats lined up to see and his future with Joanne and Lana is all mapped out in front of him – he feels as if he can conquer the world. But, by the end of the day, his arrogant attitude has cost him all the things he holds dear. In S22 E44, Toby spies a female patient he knew from medical school and offers to treat her broken leg. She teases him that she didn’t think he’d make it as a doctor. Later – disregarding Sean’s advice – he completes her leg surgery alone. However, the post-op X-ray shows that Toby has made a big orthopaedic mistake. In S22 E48, Ruth is waylaid by a journalist who’s been speaking to Toby. He wants to know about her suicide attempt and when she realises it’s Toby who’s told him she confronts him in front of his mother. Toby also confesses about his cover up over his friend patient’s injury. His mother, in despair, disowns him whilst Ruth offers him support when he breaks down.

In S23 E7, Toby covers up a mistake for Adam but Jordan is suspicious. In S23 E9, Toby frustrates Jordan after failing to diagnose a simple case of trapped wind whilst Ruth continues to get his praise. In S23 E10, both eager to please Jordan, Ruth and Toby see their chance to impress when the casualties of a major road accident, are brought into the ED. Ruth is irritated when Jordan lets Toby send her to work with Adam, while Toby gets to assist Jordan. Later, Toby is shocked when Ruth accuses him of fancying her. In S23 E12, rejected by Jordan after a night together with him, Ruth turns to Toby for support, but instead gets the surprise of her life when she catches him in bed with Ben Harding, the hospital counsellor. In S23 E13, Toby is in a good mood after his night with Ben but is uncomfortable when Ruth lets slip that she saw them in bed together, and denies there is anything going on. In S23 E14, Ruth worries that Toby isn’t coping after his night with Ben. After a confrontation with Ben, she reports him to Jordan for taking advantage of Toby. She is, however, unwilling to address the similarities between Ben and Toby’s situation and her own with Jordan. In S23 E15, Ben confronts Toby about his suspension. However, although Toby tries to sort the situation out, he cannot bring himself to admit to Jordan that Ben did not put him under any pressure to sleep with him. In S23 E16, Toby discovers from Kelsey that rumours about his night with Ben have spread. He asks her to quash them, despite her assurances that no one really cares about his sexuality. In S23 E18, Toby decides to withdraw the allegation against Ben. In his naivety, Toby thinks this will make things better, but it doesn’t. Ben, however, is furious. Later, at the staff party, he drunkenly insults his colleagues and makes a life-changing announcement to quit. On his way home Toby becomes trapped in a rowing boat, which starts to sink. In S23 E19, Jay, who is on a passing party boat, spots Toby in the water and dives in to save him. Toby later comes round in hospital, where his father tells him not to throw away all his years of training. But Toby is adamant, and tells his dad he’s gay. Jordan, meanwhile, tells Toby he can’t leave immediately as they are stretched to the limit. Where Toby struggles with the pressure, Ruth methodically deals with her patients one by one. Toby is put under more stress when the driver who caused the accident asks him to lie. His day goes from bad to worse when he misses a crucial scan and Jordan agrees he should leave immediately. A little girl cut badly from the train crash, causes havoc and violently lashes out. Finally, Ruth turns to Toby and asks him not to leave because she needs his help. Toby succeeds where everyone else has failed, and gets the little girl to open up. Ruth and Toby share a moment together at the end of the frenetic day – they have been through so much together. Ruth is sad to see him leave, but Toby encourages her to stick with it, and he tells her she’s cut out to be a surgeon. As he leaves the hospital for the final time, Toby is pleased to be met by Ben.

Memorable Moments

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Former CASUALTY actor Matthew Needham can currently be seen in a theatre production of ‘Summer and Smoke’. Following a critically acclaimed, sold-out run at...

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