Episode 8 is the 1100th episode of Casualty and the eighth episode of the 33rd series. It was preceded by Episode 7 and followed by Episode 9. The episode was directed by Alex Jacob and written by Rachel Paterson.
Blake tries to spend more time with Omo, but she is soon taken into the ED as she struggles with her schizophrenia. Jacob is left shaken when he sees her, and, after he tells Blake about her illness, he tells him that she is scared of him. Blake manages to convince her that the medical staff are trying to help her, but the voices in her head start telling her that Jacob has deliberately poisoned her as revenge for her treatment of him during his childhood. After she tries to remove the "poison" herself, Jacob tries to help her, but the voices convince her to make a break for it, forcing him and Elle to sedate her. Blake witnesses the incident and accuses him of abandoning her, but Jacob tells him about what happened between him and her. Later, Elle encourages him to allow Blake to continue seeing Omo and reminds him that their relationship is different.
Iain and Ruby fail to resuscitate a man who has overdosed in a park, and Iain smashes the window of the ambulance in frustration. Ruby covers for him, and she tells him to be honest with her. However, they are soon interrupted as a car shoots past carrying an unconscious driver and his son steering the wheel. Ruby is amazed when Iain succeeds in stopping the car, but Jan admonishes them for compromising two vehicles. After their shift, Ruby encourages him to speak to someone about his feelings, be it her or a professional.
Meanwhile, after Ruby agrees to switch rooms, Gem invites Rash over. However, as they prepare to have sex, Rash loses his nerve and vomits. When he doesn't admit to his nervousness, she breaks up with him.