Berena and the anastomosis: the unseen patient parallel storyline.
Holby love a good “patient parallel” storyline, and after doing a little thinking I believe that’s what we got with Berena last night, even though their patient was unidentified and we knew absolutely nothing about him… I reckon the highs and lows of surgery scenes with Berena operating on the unknown man from last night do actually serve as a telling parallel with the course of their storyline during the two-parter.
An anastomosis (the part of the operation they were carrying out which Bernie had to re-do inside the 30 mins time limit) is a surgical term for the creation of new connections between previously separate vessels- a very apt metaphor for the reunion of Berena from a long-term separation. The progression of creating a stable attempt at an anastomosis and the subsequent ups and downs of the procedure could be said to mirror the trajectory of the Berena storyline in the two-parter.
(1) Off to a good start, but trouble lies ahead
All seems to be going well at first (both with the reunion and the operation), and Donna comments that it’s like watching a ballet… a nod to the fact that whilst it may look beautiful and seamless, Bernie and Serena are still dancing around the unspoken issues that they’re facing.
Once they start to talk about Nairobi and Greta (and the “you’re not family” slip of the tongue), it all starts to fall apart in theatre once the first attempt at creating an anastomosis fails and a catastrophic bleed happens.
This event is later mirrored by the events of the “I choose you” scene- it’s a solution, but by no means one which satisfactorily deals with the unspoken issues that Bernie and Serena are facing and therefore doesn’t hold fast when tested when Greta is readmitted and Serena holds Bernie accountable for her actions.
The bleeding vessel in this instance is the aorta, signifying a “broken heart”. Despite all appearing to be well at first, when Serena cuts the ties on the stitches there is a tear and suddenly the cavity is full of blood. Bernie arrived at Holby with a “broken heart” both physically and metaphorically which was healed during her time there. She also went running off into the sunset wearing a charity bib which said “Holby Healthy Hearts” so there is a track record of using heart symbolism with Bernie.
Now that Greta has been readmitted and Serena is lashing out because she scared of what she might lose, she will end up pushing Bernie away through their arguments and leave them both “broken hearted”. The cutting of strings/stitches is significant as it hints at a cutting of ties. Whether these ties are Serena’s links to Holby, or her link to Bernie remains to be seen… it is possible that she presently views the situation that she can’t have one person without having to cut ties with the other hence the ‘choice’ that she makes when talking to Bernie in the office.
However, returning to the theme of threads, we know from the repeated references in this episode that Serena has been practicing knitting, and this involves joining threads into one united unit to make something greater than the sum of the original parts. So, there will be trouble, but Serena will play a role in ‘knitting’ together the damage she’s done in order to make amends and build something new. This may also be a literal play on words of the troubles of navigating a ‘close knit’ family?
(2) A timer is set for 30 minutes to redo the anastomosis after Bernie asks if Serena trusts her judgement
This is the amount of time left to fix the broken heart and points to the short amount of time we have for Berena to be fixed in the course of the following episode. Serena is adamant that she always believes in Bernie, but warns of the risk of long-term damage to the patient (paralysis) if the procedure isn’t completed within 30 minutes. Interestingly, paralysis was also the risk attached to Bernie’s operation when she first arrived at Holby with an unstable neck fracture (”I’d rather be dead than paralysed”), and is something that Bernie holds a greater fear of than death. Aware of the risk, Bernie proceeds. Whilst Bernie’s decisions appear rash to her upon her subsequent reflection in the office with Serena, Serena justifies her behaviour by stating that she was ‘being the greatest trauma surgeon the country has to offer’. This shows how high the stakes are, and what women both know (and fear) that they may stand to lose.
This concept of acting in the interests of one’s country/for a higher cause and acting rashly suggests that Bernie’s future actions may appear rash to an outside eye, but that she genuinely believes that she’s acting in the interests of the greater good, no matter the personal cost to her (something she’s more than used to from her military experiences). It could be read that in order to avoid having Serena make a choice between her or Holby, Bernie chooses to stand aside despite her own feelings in order to put Serena’s welfare above her own. Perhaps she decides to quietly slip away once the baby has safely arrived as she thinks Serena has already made her choice?
(3) We reach 15 mins to go and it isn’t looking positive.
In theatre, Serena reckons they won’t make it and Bernie asks if she believes in her. Serena replies, “Always”.
There will be a realisation at some point from Serena about her behaviour towards Bernie and she is distraught when she then reckons that she’s lost Bernie for good. However, if this is read as a parallel, it is we as viewers who are being reminded to believe in Berena as a couple who can withstand hardship and make it through together as they ‘always’ have.
(4) 2 mins to go and things are looking critical.
Bernie is frantically trying to complete the procedure in time. She quips about the countdown clock “who’s stupid idea was this?” and replies “you should have stopped me” to Serena and Donna.
This indicates a last minute attempt to salvage things, where Serena will have to find Bernie and stop her from leaving and carrying out her plan. She will stop her long enough for them to have a conversation.
In the scene, it is Serena who removes the clamp from the aorta (metaphorically representing her coming to terms with and expressing the truth and opening her heart) and this is mirrored by Bernie saying “moment of truth”.
I believe that this indicates an honest, heartfelt discussion where they finally let things go and properly sort things out between them.
Meanwhile, the patient lives! And in this parallel, Berena live! The cheering and clapping in the scene are not only the theatre staff, but thousands of invested Berena fans getting their just reward for making it through the angst fest!
Serena and Bernie leave the theatre staff to wrap things up and slip off to one side. Serena puts her arm over Bernie’s shoulder.
We know from the promo photos that they leave the hospital together, presumably with a clear way ahead of them!
All in all, if I’m anywhere near right, Patrick Homes is one clever writer to write that level of parallel!
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