"This is Unknown… Female by birth…" Iain started, uncertain and stumbling over his words, which was unusual for him, as he paced into the ED, pushing a trolley. A teenage girl of about seventeen was being wheeled through on the stretcher, and gauze could be seen wrapped tightly around her chest, where her plaid shirt lay torn, open and bloody. Dylan couldn't help but be surprised by the sight.

"GCS 15, pulse 95, BP 120 over 60, in and out of consciousness since boarding…" Iain continued rattling off statistics, and Dylan forced himself to step across the ED and grab the other side of the trolley.

"Straight to cubicles please." He uttered, steering the stretcher towards the double doors "-Cause of incident?" he glanced back down at the currently unconscious girl, messily cropped curls clustered around her pale, sloping face. He felt a shiver pass down his spine at the evidently pained expression carved into her skin despite the painkillers. He knew what he was to hear expecting before he even heard it.

"We suspect attempted self-breast tissue removal" came the soft reply from Iain.

Seb groaned from across the room as they lifted the girl from the trolley onto the bed.

"You okay Seb?" Dylan asked, snide with sarcasm as he turned to face him, fists on hips.

"Fine… Just makes me retch to think there's a-" He paused, "Don't worry" he muttered, reading the expression flashing across the faces of the rest of the doctors in the room. He turned and continued filling needles.

Dylan shook his head at the childish attitude of the new F1 and turned to Rita, calling her name. The small blonde nurse nodded and came over to where the girl lay, grabbing a clean clipboard from the end of the bed.

"Excuse me, please… Is my daughter here?" A straight-backed woman in a burgundy pencil skirt and flowing white blouse with neat, black curly hair all but ran up to reception where Noel stood, tracing the phone longingly. His eyes snapped up and he was silent for a second. She had hazel-brown eyes and a small, pouted mouth, her skin tone contrasting a little with the darkness of her hair. Her eyes were wide and worried and her hands were clasped around her bag.

"S-sorry" Noel coughed and looked down at the bare notebook in front of him. "What's her name?"

"Adrienne… Adrienne Chiltern –I got home from work and my neighbour said an ambulance had been called. No one thought to phone me… There's blood on the bathroom floor…"

"I'm so sorry, that isn't the usual procedure of the NHS… Someone should have called you." Noel rubbed his forehead and tapped his pen against the pad again. "I can put a call through to resus… see if she's there. If you'd like to wait in the waiting area" he gestured towards the rows of chairs, housing pre-patients in various levels of distress, "I can put you through once they've found her."

Something flashed across the woman's face, but it was so brief, Noel barely picked up on it. "What do you expect me to do? Aren't you supposed to know who you have in here?"

"We are, but what's most likely happened is that your daughter was unconscious at the scene or needed to be moved quickly and the paramedics didn't have time…" Noel trailed off as Cal came over, grabbing a new stack of folders from the shelf. "Ah Cal, could you try and find Adrienne Chiltern for Mrs…" He trailed off once more.

"Miss Chiltern, Miss Julia Chiltern" The woman reached out her hand briskly and Cal, also captivated by the woman's good looks, desperately juggled the folders in order to take it.

"Of course I can" He smirked at her flirtatiously, backing off when she glared at him for a split-second.

"Thankyou" she muttered grimly, walking back to the waiting area and grimacing as she took a seat furthest away from the coughing, bleeding people, staring into space glumly.

Dylan leant over the patient, ready to cut away her shirt, when she sat up fiercely, despite the pain.

"Make one more move" she hissed.

"Hello, I'm Dr Keogh, you're at Holby City Hospital-" Dylan began, but he was cut off by the girl's struggling.

"No! I thought I was going to die… I didn't need help I can do this myself!" She thrashed against the hands of both Dylan and Rita, before paling, her eyes widening.

"It's okay honey" Rita uttered softly, placing a hand on either of the girl's shoulders. "We need to get to your chest darling, you're quite injured and it could get worse…"

The girl looked up at Rita, but Rita could see she wasn't truly seeing. It was as if she was looking through her to behind.

"Sorry" she whispered, lying back down and cringing as Dylan came closer with the scissors to cute her shirt away.

"I'm afraid I'm going to have to cut it because I risk injuring you further if you just take it off" he explained, and she nodded through hazy eyes.

"You okay honey?" Rita asked, taking the girls hand and trying not to wince when she squeezed it hard.

"Yeah sorry" The girl muttered, twitching anxiously as Dylan peeled the cut shirt away from her front.

"Can you explain what happened?" Dylan asked, but got no response from the girl who shook her head.

"We really need to know honey." Rita asked her gently.

"I'm sorry" she whimpered, coughing brokenly, "It was all a mistake; I just wanted to feel pain."

"Don't apologise sweetie" Rita whispered, removing the gauze pads gently, "I think we need more morphine" she told him, as Ethan left to order a CT scan.

"500mg" Dylan uttered, as he examined the girl's chest. "Two incisions made, we'll wait for CT and if it's all-clear on soft tissue damage, we can stitch, and you can be out of here." He tried to sile down at her, but was still haunted by the expression on her face. "We'd recommend referral to one of our clinical psychologists" he offered, but still got no response.

Trying not to sigh, Dylan applied new gauze to her chest and a nurse passed her a gown. "Put this on… You can draw the curtain, and then we'll take you up to CT" The nurse smiled and Rita helped her to sit up, as Dylan walked away.

Once they were alone together, the girl snapped into life, "Do you help people?" she asked, grabbing Rita's lower arm and staring hard into her eyes.

"Yeah, I'm a nurse, of course I help people" Rita crouched down to be at eye level with the girl, whose legs were swung over the edge of the bed, "Is there something you need to tell me?"

"I'm not a girl."

"Okay. I understand."

"I can't keep doing this and pretending to be Adrie-" The boy cut off mid-sentence and licked his lips nervously, taking the gown from Rita.

"What do you mean?" Rita asked. Having done her extended medicine certificate in gender transitions, she was fairly sure she knew, but she had to check.

"My mum doesn't believe in it, but it's fine. I shouldn't be a boy because I'm born a girl it's fine."

"It's not fine if you're hurting darling" Rita reached out, but the boy shrank away from her touch, so she pulled her hand back in.

"If I say something, will you believe me?"

"Of course I will."

"CT's ready!" Max called, entering "… Isn't she supposed to be in a gown?"

"Yes thankyou Max, we were just getting to that" Rita muttered, drawing the curtain.

"Please don't leave me" the boy whispered, his hand still on Rita's arm.

"I'll be just outside the curtain, okay?"

"Oh okay" he whispered, quieter this time, and removed his hand from her arm.

Miss Chiltern sat across from a man with a bleeding wound on his arm and picked up her phone. "Little shit had better not tell anyone if she wants to keep her dignity." She wrote to her boyfriend, smiling as she pressed send.

"If you'd like to lie down here, the CT should take about 20 minutes" Dylan told the boy, helping him get into the correct position. "Ready?"

He nodded, clenching and unclenching his fists and Dylan gave him a small half-smile back, which only he caught. He decided he like Dr Keogh.