Episode 34 is the 1126th episode of Casualty and the 34th episode of the 33rd series. It was preceded by Episode 33 and followed by Episode 35. The episode was directed by Daikin Marsh and written by Dana Fainaru.
In his house, Iain tries to complete a guided meditation exercise, but he loses his patience and decides to run to work. In the shower at the ambulance station, he inspects his scar, and, as he dries himself off, he finds his pebble.
At the emergency department, Duffy arrives while arguing with her landlord over the phone about issues with her boiler. Charlie offers her a coffee and a blueberry muffin as a "peace offering", but she declines. He asks her if they could talk later; she posits that there is nothing to talk about. Meanwhile, Gem repeatedly messages Iain after he forgot to take her into work, but he ignores it and takes his antidepressants. Ruby and Jan arrive and welcome him back.
At their house, Holby residents Maggie McKiernan celebrates her tetraplegic husband Jimmy's 40th birthday and presents him with a cake. His tracheostomy tube begins to fill with sputum, and Maggie tells her son Aaron to talk to his father while she changes his sister Maisie's nappy.
Back at the ED, Elle receives a call from the Royal Wiltshire, and they ask her to start working there as Clinical Lead in two weeks time. Jacob overhears the news and congratulates her, but he dares her to tell Connie about the news as she berates Will for failing to attend his second interview for the consultant post. Connie calls for a brief meeting in admin and informs the team that the department is beyond capacity. She asks Archie to work with Elle in resus and coldly tells Will to treat patients with minor injuries. Robyn asks Will if he has told her about Toby's case, and, to her disbelief, he tells her that he has not. Duffy interrupts and presents her colleagues with stickers, badges and a collection box for her campaign to make the ED more dementia-friendly. She explains that "the monster under the bed is far scarier when it's in the shadows" and proclaims that she's "out". Charlie assures her that it is a fantastic idea, but she tells him that, if he wants to help, he can stop giving her special treatment and give her heavier duties.
Noticing that he has not eaten, Ruby offers to take the drugs bags to the ambulance so Iain could finish his breakfast, but he declines. He continues to receive calls from Gem, but he ignores them. Ruby starts to show concern for his actions, and he tells her to stop being so wary of him. He asks her if they are ready to go, and Ruby informs him that Jan would be accompanying them; the latter suggests viewing it as a team-building exercise.
In cubicles, Duffy treats a young woman named Katy Hibbard who has injured herself while sparring and believes that she has fractured a few ribs. Katy asks her if the hospital has anything that could make her injury heal faster, and Duffy insists that there is no easy fix. Noticing that her heart rate has increased, Duffy asks Katy if she is on any pain relief, and she claims that she has only taken some paracetamol. To her surprise, her father Andy appears, and she tells him that she slipped at a party after having too much to drink. Worried, he decides to call her supervisor, but she requests him not to get involved.
Elsewhere, James begins to seize, prompting Aaron to call for Maggie. He tries to stop his father from rolling off his bed, but he fails. Maggie rushes in and, horrified, begins to blame Aaron for what has happened. Back in cubicles, Duffy tells Andy that, although Katy has equal air entry in both lungs, she still needs to be checked for a punctured lung. As he leaves to answer a phone call, Katy apologises to Duffy for not being honest with him about the circumstances of her injury and tells her about the death of her brother Evan who was a boxer. Andy returns and assures Katy that he is not going anywhere, and Duffy decides to get a urine sample and perform an ECG. She asks Katy if she has any pre-existing conditions or is taking any medication, and she says no.
Iain, Ruby and Jan arrive at Maggie and James' house, and Iain checks James over and spots that his left leg appears shorter than the right. Ruby tries to tend to Aaron's head injury, but he runs to his room. Jan asks Iain to go after him as she does not want him to cause any further damage to his chest while lifting James. In Aaron's bedroom, Iain attempts to look at his gash, but he pushes his hand away. Iain informs him that he needs to go to the hospital to have it seen to, but Aaron refuses and tells him to "get off [his] case". Downstairs, Jan informs Maggie that it appears as though James has fractured his hip and needs to be taken to the hospital. Iain tells Jan that Aaron's injury requires stitching, but Aaron continues to resist treatment. Maggie berates him, and Iain assures him that he would get him seen to as quickly as possible.
In admin, Andy wants to know how long it will take for a doctor to see Katy, and Duffy tells him that the department is incredibly busy and that she will be seen to as quickly as possible. He apologises and donates some money to Duffy's dementia campaign, explaining that his aunt had the disease. Duffy tells him that research into dementia is developing all the time, and she reveals to him that she is living with it. She spots Ethan and asks her to treat Katy, and Charlie assures Andy that Duffy is the best nurse he has ever worked with and has more knowledge than some of the doctors in the department.
Meanwhile, James is taken into resus. Maggie asks Archie if he has an infection, and she informs her that it is too early to tell. In cubicles, Iain is welcomed back to work by his colleagues, including Connie. Will tries to speak to her, but she shuts her office door in his face. Jokingly, he asks if he should "go top [himself]", not realising that Iain is standing nearby. He apologises to him, and Iain tells him not to worry about it. Nearby, Ethan assesses Katy and explains that she has reduced air entry on one side. Andy points out that Duffy claimed that she had equal air entry and remarks that it is good that "someone capable" is checking her. Ethan explains that these symptoms develop over time and assures him that Duffy did the right thing by making them wait. In the corridor, Andy complains to Ethan about Duffy being allowed to treat patients in her condition, and, when Charlie appears, he brings up his comment about her knowing more than the doctors. He tells Duffy that he holds nothing against her and that he feels sorry for her, but she tells him that she does not want his pity. Charlie tells Andy that he will take over treating Katy and will hold a discussion about it later that day.
On their way out of the department, Ruby asks Iain if he is okay after meeting everyone for the first time since his suicide attempt. Gem rushes over and asks him if he has been getting her messages, and he tells her that he has been busy working. Ruby assures him that she is just worried about him, but he remarks that everyone "tiptoeing around [him]" is making him "lose the will to live". She is shocked by his statement, and he tells her to lighten up as it was a joke, but she insists that it was not funny at all. In the staff room, Charlie apologises to Duffy and explains that he was trying to get through to Andy that the hospital does not accept any form of prejudice towards any member of staff. He asks her what she wants him to do, and she orders him to stay out of it, explaining that Andy is a vulnerable relative who has already lost a child in the department. She insists on dealing with the fallout from making her dementia public and tells him to stop controlling her.
Outside, Iain complains to Jan about not being allowed to go out on his own and not being able to carry anything. She asks him where Ruby is, and he explains that she is annoyed at him for making a joke about suicide. She tells him that he cannot ignore what happened. In cubicles, Katy apologises to Duffy for her father's treatment of her. Duffy insists that she can look after herself and tells her that continuing to lie to him about her boxing will only make matters worse. Once Andy returns, Katy takes the codeine Duffy has given her, and Duffy tells him that she will be back once the results come back. Elsewhere, Will and David try to treat Aaron's cut, but he resists treatment. Iain overhears and tells him that he needs to let them treat it or they would have to sedate him. He asks him if he wants Maggie to be there with him, and Aaron says yes. Iain goes to resus to ask Maggie to visit Aaron, but Archie interrupts and informs her that James needs to have an operation. He tries to tell her that her son needs her, but she insists that he is just being difficult. Jan hears and tells him to let Will and David deal with Aaron themselves.
Back in admin, Elle asks Archie if Connie is in her office, and Will receives a large envelope from Noel. When he opens it, he finds a card from Toby thanking him for the party. Robyn asks him why he has not told Connie about him, and he explains that she would kick him out of the hospital sooner if she finds out that he broke the rules and held a party in a cubicle. Elsewhere, Duffy tells Katy and Andy that they have found no sign of a pneumothorax, but Andy points out that his daughter still looks ill. Concerned, Duffy decides to get Ethan, and Katy begins to have a seizure. Outside resus, Aaron tells Iain that Maggie blames him for James' disability. Archie informs Maggie that the chest X-ray confirms that James has a chest infection and that the anaesthetist believes that he is no fit state to be operated on. Upset, she yells at Aaron, telling him that she should never have left him with him. Iain tells her that Aaron is scared for his father and that the accident was not his fault, but Maggie begs to differ. Aaron encourages her to admit that she believes that it was his fault, and she berates him for not keeping his foot on the ladder. Jan and Ruby overhear the commotion and the former tells Iain that he has made the situation worse. She asks him to hand over his radio and tells him that he is done for the day. Ruby insists that she had to say something as Jan wanted to know where he was, and he sarcastically thanks her.
Aaron returns home and, in anger, starts beating and kicking bits of the studio that he and James were building before the accident. He strikes one of the posts, causing several loose wooden beams to fall on top of him. Meanwhile, in the peace garden, Gem sits with Iain and offers him a sandwich. In resus, Duffy and Ethan treat Katy, and the former believes that she is experiencing the effects of an overdose. She insists that she did not give Katy too much medication, but Andy is sceptical and suggests that she is covering up her mistake. Overwhelmed, she runs out of the room. Outside, Iain overhears Maggie panicking after receiving a call from Aaron, and he goes with her to help him. In the staff room, Duffy tells Ethan that she thought she was being brave by confronting her dementia, but now she believes that people cannot see past it. He assures her that the problem is other people's prejudices, but she worries about being seen as culpable if her patients begin to deteriorate. Ethan affirms that she did not give Katy too much codeine, and Duffy suggests that, because of her reluctance to accept any analgesia, she may have taken something else. Curious, she goes to investigate. Meanwhile, aware that she wants to speak to her, Connie calls Elle into her office.
In the studio, Iain and Maggie find Aaron, and he claims to have injured his ankle. Iain investigates and finds that he has sustained a dislocated open fracture. At the ambulance station, Gem informs Jan and Ruby that her brother went with Maggie, and the two paramedics make their way to the scene of the accident. In her office, Connie opens her blinds and asks Elle what she wants to talk about. Elle tells her that she is leaving, and the Royal Wiltshire wants her to start working there in two weeks. To her surprise, Connie congratulates her, claiming that "life goes on". Elle tells her that she thought she would be disappointed or angry about her departure, but she claims that "that pleasure is reserved for someone else", referring to Will. Elle suggests that she would want to keep him in the department because of his treatment of Toby.
Outside resus, Duffy asks Andy what medication he is taking for his back pains, and he tells her that he is taking tramadol. Katy admits to taking it and apologises. Duffy explains that tramadol is a powerful painkiller that reacts badly with codeine and tells her that she is very lucky that it happened in the department. Back at the studio, Iain gets Maggie to help him relocate Aaron's ankle, and they successfully carry out the procedure. Aaron apologises to his mother, and she reciprocates it. Jan and Ruby soon arrive, and they take him to the ED. As he is taken into resus, Connie goes to treat him, but she quickly loses her confidence and asks Will to take over. Once Iain hands Aaron over to the hospital staff, Maggie thanks him.
On their way out of the department, Iain congratulates Jan and Ruby for their work, but Jan rebukes him and reprimands him for going off on his own. Ruby tells him that they need to work as a team, but he accuses her of "telling tales". Surfeited with their feud, Ruby walks away, prompting Jan to berate him for not considering her feelings after she saved his life. She tells him that what happened affected them as well and that they are not over it yet. Elsewhere, as Katy is taken up to the wards, Duffy tells Andy that she knew about her boxing and posits that it is her way of getting over her grief. He tells her that he hopes that she is around for a lot longer and mentions Charlie's high praise of her. David gives her the blueberry muffin that Charlie bought for her in the morning and explains to her how hard he fought to get her it.
At the ambulance station, on his way out, Iain stops by Ruby and says "goodnight" to her. In the ED, Connie gives Will the card Toby made for him and offers him another interview the following day. Delighted, he decides to buy his colleagues drinks. Nearby, Duffy tells Charlie that she slept with Bill because she wanted to feel like herself again, and she did not felt that way with him. She suggests that, since her dementia diagnosis, he has been treating her like a patient; she tells him that she wants to be his wife instead, and they need to make the most of the time that they have left together. The two embrace.
- Michael Stevenson as Iain Dean
- Cathy Shipton as Lisa "Duffy" Duffin
- Derek Thompson as Charlie Fairhead
- Maddy Hill as Ruby Spark
- Amanda Mealing as Connie Beauchamp
- Genesis Lynea as Archie Hudson
- Jack Nolan as Will Noble
- Rebecca Ryan as Gem Dean
- Jaye Griffiths as Elle Gardner
- Charles Venn as Jacob Masters
- Jason Durr as David Hide
- Amanda Henderson as Robyn Miller
- Tony Marshall as Noel Garcia
- Di Botcher as Jan Jenning
- George Rainsford as Ethan Hardy
- Claire Rafferty as Maggie McKiernan
- Ty Tennant as Aaron McKiernan
- El Anthony as Andy Hibbard
- Shanay Neusum-James as Katy Hibbard