Episode 38 is the 1130th episode of Casualty and the 38th episode of the 33rd series. It was preceded by Episode 37 and followed by Episode 39. The episode was directed by Fiona Walton and written by Chris Murray.
Two men on a motorbike - Jason and Chris - attempt to steal a man's phone, but he wrestles Jason to the ground, causing Chris to hit an elderly woman named Barbara while trying to escape. As passersby gather around Barbara, Dani claims that she is a paramedic and uses Ruby's stethoscope to assess her condition. She prepares to perform a tracheotomy with a pocketknife, but, once Ruby and Iain arrive and recognise her, she runs away.
At the emergency department, Connie leaves to attend a discussion panel at the National Conference of Acute Trauma and leaves the department in Ciaran's hands. Outside Omo's house, Jacob wakes up to find Jet standing by his car. Once she returns to the house, Jacob realises that he is late for work. In admin, Ciaran informs the rest of the staff that he is initiating a time and motion study where they have to log their activities in the department. Archie suggests that he is "checking up on [them]", but he claims that he is just gathering data to identify areas for improvement. Jacob subsequently arrives in the department, and Ciaran reprimands him for being late again.
Elsewhere in Holby, Chris informs the gang he and Jason are working about their failure. The leader, Brandon, suggests that Jason will tell the police, but Chris maintains that he will not. In resus 2, as Jason receives treatment for his injuries, he spots Barbara in the main unit. Once Ruby finishes handing her over to Archie and the resus team, she tells Iain that she needs to speak to him; concurrently, Dani returns to her house.
In cubicles, Dylan treats the burnt foot of a woman named Magdalena Spellbinder who claims to be an "alternative healer, spiritual advisor and past life regressionist" and dismisses her profession with sarcastic responses. In the staffroom, as Marty criticises Ciaran's study, Robyn reminds him and Jade that a nursing representative is coming in later to deal with the bursary. Jade expresses interest in applying, and Marty mocks her, telling her to "dream on". Dylan asks her to help him treat Magdalena's foot with larval therapy, and she agrees enthusiastically.
In resus, Ethan and David try to get Jason to tell them their name, but he panics when he spots David wielding a syringe. Jade communicates with him using sign language, and he tells her his name and that he is scared because he does not know what is happening. In her cubicle, Magdalena eagerly agrees to be treated with maggots, but Dylan insists that his trial is rooted in science rather than holistic medicine.
At the ambulance station, Jan pins a notice about a paramedic support group on the noticeboard, and Ruby decides to go. Before Jan leaves, Iain stops her and prompts Ruby to open up to her. At home, a sobbing Dani reads up on paramedic science, but she becomes frustrated and throws her books onto the floor; she begins to break down. In resus, Barbara tells Archie that her son Jim lives in Vancouver, but Archie still insists on contacting him. Barbara asks her if she will be able to visit him and his family, and Archie urges to take "one step at a time". Next door, Jason insists on having nobody visit him, and Jade catches him looking at Barbara. Meanwhile, Chris arrives outside the department. Ethan informs Jade that Barbara was injured during an attempted robbery. She asks Jason if he is responsible, and he asserts that it was a mistake. In her office, Jan admonishes Ruby for getting involved in Dani's personal life and decides to call the police. Ruby elects to call her instead, but Jan warns her not to speak to Dani under any circumstances. She asks Jan what will happen to her, but she has not decided yet. On their way out, Ruby asks Iain what he thinks she will do, but he does not know either.
Back in the ED, Dylan assesses the sensation in Magdalena's foot, and, when he deliberately does not tap it, she claims to have felt something, prompting him to instruct Jade to not leave her. As Jade applies the maggots to her foot, Magdalena tells her not to "beat [herself] up about everything", and Jade assures her that she will be fine. In resus, Barbara complains of a headache and requests Archie to call her son. As she leaves resus, Ciaran points out that she has not initiated her time and motion study, and she asserts that she has been busy saving lives. Jason is taken back into resus, and David informs Ethan that the BSL interpreter has been delayed. Ethan suggests that they need Jade, and he goes to talk to the police.
Elsewhere, Dani tries to call Ruby, but she does not answer and puts her phone in her locker. In cubicles, Ethan asks Jade to help him get more information from Jason, but she notifies him that she cannot leave her post. When she spots the nursing representative, she puts Magdalena's dressing back on, but, as soon as she turns around, they are gone. In resus, Chris demands to know what Jason has said to the medical staff, and he insists that he has not said anything incriminating. Chris tells him that he has blown his chance of getting into the gang, but Jason claims that he does not want to anymore as he only wanted to join to feel safer. When Barbara begins to deteriorate, he tells Chris to go and promises to take the blame.
At her house, Dani continues attempting to call Ruby but to no avail. She leaves the house and drives away, but she swerves to avoid hitting an oncoming vehicle and crashes into a parked car. In resus, the team attempt to resuscitate Barbara, but Archie believes that she is too far gone and suggests stopping. Her colleagues agree, and Barbara is pronounced dead. At the scene of the crash, an ambulance arrives, but Dani locks her doors and refuses to speak to the attending paramedics. By the department's coffee shop, Jan informs Iain and Ruby that Dani has been involved in an accident and is refusing to speak to anyone apart from the latter, and she allows them to deal with her.
In cubicles, Dylan confronts Magdalena about the circumstances of her injury. He explains that she has peripheral neuropathy and suggests that she already knows that. She admits that she was using a wheat-filled heat bag to soothe her arches and acknowledges that she may have left it in the microwave for too long. After she states that she slept for several hours, she also admits that she has issues with alcohol abuse. Dylan empathises and goes to find Jade. Dylan finds her in resus talking to Jason and reprimands her for leaving her post. She believes that there is something wrong with Jason, but he claims to be busy treating his own patients and asks her to come with him. Outside the department, Chris informs Brandon that Jason will take full responsibility for the accident, and Brandon assures him that he's "sound" and tells him to leave the hospital grounds; Chris has second thoughts. Back inside, Magdalena gets out of her bed to reach for a glass of water and slips. Dylan and Jade find her and help her back onto the bed.
At the crash, Iain tries to get Dani to unlock her car, but she refuses to budge, forcing him to allow Ruby to speak to her. Dani insists that she caused the accident by not answering her calls and that she just wants to be a paramedic, but Ruby asks her what her real motive is - Dani admits that she does not know what to do without her mother. Ruby acknowledges that wanting to help others like she helped her mother is admirable, but she reminds her that she is not qualified to be a paramedic and suggests that Tracy would want her to open the door; Dani eventually agrees to open the door.
In resus, Jason explains to Jade what actually happened that morning. When he begins to complain of headaches, she examines him and finds that his injuries have been masking a rash. Dylan bursts in and prepares to admonish her, but she tells him that she believes that Jason has meningitis. As Iain and Ruby load Dani into the back of the ambulance, despite Dani's objections, Ruby elects to drive. After Dylan assesses Jason, Jade asks him if she should have noticed earlier, but he assures her that he believes that they have caught the symptoms of Jason's meningitis early. Meanwhile, Dani is taken into resus. Ciaran offers to help Archie treat her, and she tasks him with carrying out a primary survey. Ethan returns from his meeting, and Dylan apprises him of Jason's bacterial meningitis.
In reception, after Iain praises Ruby's handling of the situation, Jan decides that Ruby requires support as opposed to punishment. Ruby thanks Iain, and he reciprocates with a smile. Outside resus, Chris tells Jade that he has come to see Jason as he is the only person who is close to him, and she asks him to let her and the rest of the staff do their jobs first. However, he witnesses him having a seizure. In the main unit, Archie asserts to Ciaran that time and motion studies are not reliable as they cannot measure the value of certain activities like comforting a deceased patient's relatives. He posits that she "[sounds] like [she cares]", and she affirms that she does. She tells him that she has filled in her study to deny him the satisfaction of calling her out on it, but he asserts that he only initiated the survey to find out which members of staff would have difficulties cooperating and claims that she "came into line pretty quick".
Jade apologises to Magdalena for leaving her alone, but she tells her to stop allowing Dylan to grind her down. He subsequently returns and informs her that her peripheral neuropathy is being caused by an underactive thyroid gland and offers to provide her with literature to help her with her alcohol abuse. In return, she offers him some books about how to behave towards other people, explaining that her real job pertains to employment tribunals. Dylan, who is visibly surprised, walks away. Elsewhere, Ruby notifies Dani that she has been reported to the police and tells her to back off from her, maintaining that they cannot be friends. Apart from finding her help, Ruby declares that it is the end of her involvement with her. Chris enters resus and assures Jade that he will tell the police everything that happened.
That evening, in the staffroom of the ambulance station, Iain returns Ruby's stethoscope, and she thanks him for supporting her. He questions why she did not tell him about the situation with Dani earlier, and she asserts that she has not felt as though he has been able to deal with his own problems, let alone her's. He asks her if they are okay, and she contends that they will be, but it feels as though they need to "talk about things properly". She asks him if he is going to the support meeting with her that night; he declines.
Back at the ED, Ciaran tries to view the results of the study, but the logging software is corrupted. He informs Will that the data has been deleted and asks him if he knows anything about it when he gives a sarcastic response, but he and Archie deny any involvement. Will asks him if the loss of the data means that they would have to repeat the study the next day, and Ciaran opts to trust the staff to do their jobs properly.
At the Coach and Horses, Ruby starts the support session by discussing her experience with Dani, and she is delighted when Iain makes an unexpected appearance. During her speech, she claims that she made a mistake that snowballed due to her keeping it a secret. On the first floor of the ED, Jade visits Dylan in his office and apologises for not spotting Jason's rash earlier, but she also asserts that she is tired of being given menial tasks, including the larval therapy, and asks him if that is all he thinks she is capable of. Dylan apologises for dismissing her concerns about Jason, but he contends that he gave her the maggots as he believed that she would be good at it. He posits that she does not believe in herself, meaning that nobody else will believe in her abilities either; this inspires her.
Back at the meeting, Ruby claims to feel lucky to have the support of her colleagues and is glad to have shared her problem. The meeting is briefly adjourned, and she thanks Iain for attending; he tells her that he is glad that he came. She offers to buy him a drink, and he agrees.
- Maddy Hill as Ruby Spark
- Michael Stevenson as Iain Dean
- Gabriella Leon as Jade Lovall
- William Beck as Dylan Keogh
- Jason Durr as David Hide
- Amanda Mealing as Connie Beauchamp
- Charles Venn as Jacob Masters
- George Rainsford as Ethan Hardy
- Genesis Lynea as Archie Hudson
- Jack Nolan as Will Noble
- Amanda Henderson as Robyn Miller
- Shaheen Jafargholi as Marty Kirkby
- Di Botcher as Jan Jenning
- Rick Warden as Ciaran Coulson
- Georgia Hughes as Dani Mallison
- Seroca Davis as Jet Campbell
- Naomi Sheldon as Magdalena Spellbinder
- William Grint as Jason Nicol
- Brandon Plummer as Chris Nicol
- Caroline Guthrie as Barbara Cassano
- Matt Reed as Brandon Nott
- Jâms Thomas as Hari Asher