Murdoch Mysteries

Mrs Quigley, age 46,

been suffering for several days

since experiencing a blow to the stomach.

Will you describe your symptoms, ma'am?

I've explained it already.

It hurts here.

The patient reports abdominal radiating to the left shoulder.

And she's been dizzy and tired.

I get tired every time I come to this godforsaken place.

These symptoms are consistent with a lacerated spleen, sir.

Surgery is indicated.

And how would you expose the spleen to repair the damage, Dr Dixon?

By partial excision of one or more ribs,

followed by sub-pleural or trans-pleural exposure of the spleen.

Very well.

Excuse me, Dr Forbes?

Would it be preferable to do a vertical incision

of the left linear semilunaris?

Preferable how?

A shorter, more comfortable recovery time for the patient

if the ribs are not excised.

Very good, Dr Ogden.

The surgery is in one-half hour.

Prepare to assist. The rest of you may observe.

Oh.

- George. - Sir.

Sir! I wasn't expecting you in today.

- Have we had a murder? - No, no, no.

I'm simply looking for my... Aha!

- Switch sequencer. - Oh.

It's a beautiful day outside, George.

Why don't you go for a walk along the boardwalk?

The boardwalk, sir.

The boardwalk is always teeming with happy young couples.

They always come out when the sun shines.

We have a call of a pickpocket at Wilton and Yonge.

Oh, then. Excellent.

Prepped and ready, Doctor.

Gauze.

Very good.

I believe the spleen is enlarged.

More gauze.

The patient is an inebrient.

Enlarged spleens are a side effect of chronic alcohol use.

Can you see the laceration?

Yes, there it is.

Would you recommend repairing the laceration or a complete splenectomy?

Due to the enlargement, a splenectomy.

I agree.

Go ahead, bring the spleen forward into the wound.

There's an adhesion to the diaphragm.

You'll need to separate that.

Scissors.

I've gone through the diaphragm.

- Heartbeat is erratic. - She's bleeding.

Can you see the injury?

- The patient's pressure is falling. - Do you want me to take over, Doctor?

No. There it is. I can do it. Sutures.

Ah. There.

Heartbeat is normal.

Very good work under pressure, Doctor.

Shall we continue?

Scalpel.

- Very well done, Dr Ogden. - Ah!

Thank you.

- Congratulations. - Thank you, sir.

The patient's son is looking for news. Would you like to do the honour?

Mr Quigley.

The surgery was quite successful.

You can expect your mother to have a comfortable recovery.

Thank you, Doctor. Thank you so much.

Dr Forbes, there's an emergency.

- It's Mrs Quigley. - Excuse me.

Mrs Quigley. What happened?

OK. Get her up. Get her up.

She's bradycardic.

She's likely bleeding internally.

Get her back to the operating theatre, we'll re-open.

She's still not breathing.

She's gone.

Is it too late to offer you my congratulations, Doctor?

You said it was a simple surgery.

That it would be all right for a student to assist!

Unfortunately, there were complications.

The spleen was enlarged, there were growths...

You told me it went well! That she would be all right!

I'm so sorry, Mr Quigley.

- Everything seemed to be fine. - And minutes later, she's dead!

I understand you're upset.

We really did everything we could do to help your mother.

What happened, then?

I don't know, sir.

But I promise you, if something went wrong here,

I will find out what it is.

We do not speak to family members like that, Dr Ogden.

- I beg your pardon? - That man's mother died a natural death.

You should not have suggested otherwise.

Well, but surely,

we need to establish how she died.

Dr Ogden.

You need not feel responsible for Mrs Quigley's death.

I saw your work.

I judged it to be correct.

- Well, I understand, but... - The spleen was more diseased

than I anticipated.

It simply could not be repaired in time.

Thank you.

Right over here, by the desk.

Mr Geoffrey's men usually wear a uniform.

I'm new. I don't have my uniform yet.

Don't you have something for me to sign?

Sir. They told me you wanted Saturday delivery.

They didn't give me a uniform, they didn't give me a paper.

They said go to the crazy new house on Lamport Avenue.

Actually, it's a modern design.

Do you want me to come back with this

- after my uniform fitting? - No, it's fine.

It can stay.

Nurse. Nurse, some help?

Of course, Constable.

What do we have here?

Well, Mr Zervos here

fell and knocked his noggin on a fence

- while trying to avoid arrest. - I was running because I didn't do anything.

We'll get the injury cleaned up and a doctor can take a look.

I go out in the morning only to be harassed by the constabulary.

It's the same story my whole life.

Ever since my papa went off to sea

and left me alone with my old uncle.

Oh, I've heard this tale before.

"A rough sailor's lad, made orphan by a winter's shipwreck."

"Play'd among the waste and lumber of the shore."

- Enoch Arden. - One of my favourite poems.

Huh.

Nurse.

You administered the anaesthetic to Mrs Quigley.

Yes.

Did you feel her response to the gas was normal?

Yes, her response was normal, Dr Ogden.

Until she died, that is.

I'm sure you're aware

that anaesthetics carry some risk.

I'm aware that the Lancet Medical Journal

has shown that chloroform is nine times more likely

to cause death than ether.

- We use ether, of course. - Of course.

- So you observed no adverse reaction? - No, I didn't.

In fact the splenectomy was not Mrs Quigley's first operation,

as you may have noticed from her chart.

- Yes, of course, I... - Since I had previously given her ether,

I knew that she tolerated it well.

Indeed, her pressure, pulse, and breathing were all normal

until the tear in her diaphragm.

You believe that tear caused her death?

I don't believe it was the anaesthetic.

If you're looking to blame a nurse, I suggest you tread carefully.

You'll find that sort of thing doesn't go over well around here.

Matron!

Will there be a post-mortem on Mrs Quigley?

Oh, I don't think so. Dr Forbes

has already signed the death certificate.

Oh, I see.

If I may speak intimately, Doctor?

- Of course. - You mustn't be hard on yourself.

I know Dr Forbes thinks very highly of your work.

Thank you, Matron.

That's very kind of you.

It's never easy to lose a patient.

No matter the circumstances. Try not to take it too much to heart.

Matron, I'd like Mrs Quigley's remains sent to the City Morgue.

That's not how we normally do things.

Yes, I understand, but I am still the City Coroner.

It's well within my purview to order a post-mortem.

Very well, Doctor.

Well, thank you for allowing me to escort you home, Nurse Graham.

I'm pleased to have the company, Constable.

It must be worrisome at times,

a young lady out alone.

This young lady is well able to take care of herself.

- Now, I meant no offence. - None taken.

I very much think nursing is an admirable calling.

What made you decide to go into it?

I was destined to be a nurse.

"Destined". How so?

My name is Florence Nightingale Graham.

- Florence Nightingale? - Mm-hmm.

Well, that is quite the name to live up to.

I do what I can.

Although my supervisor says that my hobbies

take up too much of my time.

So what, they expect you

to have no interests outside of your training?

We're to devote ourselves night and day to developing good character

and an orderly habit of mind.

Well in that case, what sort of

hobbies might distract a young lady

from such noble pursuits?

Terribly frivolous things, to be sure.

Perhaps I will show you one day, Constable Crabtree.

Well, I completed my final supervised surgery today.