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S12.E04: Episode 4


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UK Air date: January 22, 2023
US Air Date: April 9, 2023

The maternity home is thrown into chaos by an outbreak of gastroenteritis, and Nurse Crane fights to save her career. Meanwhile, Cyril encourages Reggie to seek help.

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I'm in full: "HOW DARE THEY" mode over any effort to forcefully retire Phyllis.  I kind of roll my eyes at Sister Monica Joan being the one to support Phyllis in front of the board of evil men who hate babies, love and Nonnatus House, but I did love her pointing out that Phyllis was younger than all of them.   

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Yes, the closing or taking over of Nonnatus House has been coming and going for quite a while. It's the hearth of the show, I wish it would just be taken care of until it goes off the air. The occasional angst of the mean health board is probably not inaccurate, but just always hanging there. I  loved the part with Sister Monica too. I like the non crazy Sister now, helping with stomach bugs and meetings....I don't want anything sad to happen to her.

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Scenes they cut:

Right before Nancy brings Mrs. Khatri to the clinic, there's a scene at Nonnatus House where Sr Veronica says Mrs. Chen has given them fortune cookies.  Since they're in Chinese, she offers to translate.  Sr. Monica Joan's says "To get the fruit, you must  first climb the tree." "Or make a visit to the greengocer," Sr. Monica Joan observes.

Phyllis's says "New learning will keep the mind young and nimble."  She thinks it must be about the ventouse extractor training at St. Cuthbert's tomorrow.  Sr Julienne wonders why you need such complicated new machinery when forceps have done the job for hundreds of years.

Sr. Monica Joan says the best device for the deliverance of an exhausted mother is the encouragement of her midwife.  Sr. Veronica asks what if that isn't enough.  Phyllis says, forceps and her doctor's skill.  

Sr. julienne says that forceps are not without their fault and that perhaps the ventouse extractor might offer something new.  Sr.Veronica says her motto is "Focus on the Future", and Sr.Monica Joan asks her sweetly if that came from a biscuit.

They cut out a scene where Trixie takes Mrs. Khatri into the delivery room.  She says she remembers the pain, and Trixie asks if she remembers the gas and air

They cut out part of the scene where Mr. Khatri performs the ritual with the babies. One of the other mothers asks if this is like a christening and what the babies' names are. Trixie says that Hindu parents don't reveal their baby's names right away and that for now they are Khatri twins one and two.

Mrs. Khatri says they will reveal the names when they leave the hospital.  One of the mothers says they won't lack for dancing partners since the other three mothers have all had lads, and they're the only little girls.

They cut a scene after Shelagh gets sick and Matthew brings a box of records to Nonnatus House. Nancy brings down a desk for Miss Higgins.  It has a wobby leg, but Nancy says they can fix it with a tissue.  Miss Higgins says no and that they need to prevent the spread of infection, not promote it..

Sr. Julienne then comes down the stairs and says that she has been on the phone to the medical locum office and that Dr. Wilbraham is not available, but Dr. Mukherjee is.  Miss Higgins signals her disapproval and Sr. Julienne remarks that she recalls he was very popular with the ladies to which Nancy replies not with Miss Higgins.

Right before Mr. Khatri comes by and asks about his wife and the babies, Dr. Turner and Timothy are outside talking.  Timothy says that Trixie is back in the nursery and that she hasn't had any sleep.  He asks his father how do you do it.  Dr. Turner asks me or Nurse Franklin.  Timothy answers all of you and myself too when the time comes.  He asks how do you see death coming so close, chase it away and then move on as if nothing exceptional has happened.

Dr. Turner says because in this job, you get used to exceptional things and that's the terror and privilege of it.

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I know that Sister Monica Joan hasn't been written with a whole lot of continuity (does she have dementia or not?), but I like it when they give her something to do.  Her helping out at the maternity home and telling the board that Phyllis, despite working past retirement, is younger than all of them (and making Phyllis smirk!) was one of the better parts of this episode.

Hi Tim!  Speaking of giving people things to do, he was quietly invaluable during the e.coli infection.  I want him to have a moment in the sun soon, but I suppose we'll have to wait until after he's out of school.

Loved the twins' parents giving updates on the babies via open window.  It just charmed my socks off.

And I'm glad Sister Veronica had less to do this episode, although I enjoyed how she told the reporter on the phone to go to Hell (in a nicer way, of course).  After the last episode, I want to enjoy and continue liking her...

I was truly concerned about Reggie.  He wasn't lying or being lazy, so I knew something was wrong, but I was starting to wonder if they writers would give him something that would take him off the show.  Good to see the malady was relatively mild.  And now I want to see the correlation between hypothyroidism and Down Syndrome.  (Why didn't they say Down Syndrome?  Why "his condition"?)

As long as they keep renewing this series, I will take threats against Nonnatus House with a grain of salt.  The finale of the entire show won't even show the closing, I think - just a "what happened after" scene and end it all happily (although we'll all cry buckets).

Edited by JustDucky
just a word or two...
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4 minutes ago, LtKelley said:

Down Syndrome wasn't really called Down Syndrome until the mid 1970s. Up until then, it was called "mongolism" which is now an offensive term. 

Ah.  I was wondering if the term was used in the 60s or not.  

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10 hours ago, JustDucky said:

I was truly concerned about Reggie.  He wasn't lying or being lazy, so I knew something was wrong, but I was starting to wonder if they writers would give him something that would take him off the show.  Good to see the malady was relatively mild.  And now I want to see the correlation between hypothyroidism and Down Syndrome.  (Why didn't they say Down Syndrome?  Why "his condition"?)

 

OMG I almost had a panic attack when he said he was so tired and losing hair. I think some leukemia's are more common in people with Down Syndrome, but then I remembered they  recently did a leukemia story so it probably wasn't that,

 

10 hours ago, LtKelley said:

Because Down Syndrome wasn't really called Down Syndrome until the mid 1970s. Up until then, it was called "mongolism" which is now an offensive term. 

 

And I think now here is a movement to call it Trisomy 21, the medical term.

 

6 hours ago, GaT said:

Was Reggie's hair a lot redder than it used to be?

 

I definitely thought Reggie looked a lot older.

 

I'm sure those old men doctors would never question another old man doctor about his competence.

Edited by Blackie
grammer and spacing
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Thank you again, @Badger, for a description of the deleted scenes. They seem to have cut mostly humorous lines that would have offered some relief from the heavy seriousness of this particular episode. 
I really like that Reggie and Cyril have a close friendship. I think they can sustain his character, as is, within the community through this season, and possibly into the next. 
I have been thinking about Sr. Evangelina (Pam Ferris) in the context of the ‘60s health care delivery system, and how it changed to the model in the ‘80s or ‘90s, when she played a district nurse (Where the Heart Is). I’m really curious about that oversight board’s particular prejudice against Nonatus House (and surprised that they would be so blatant about it, in light of the tremendous community support). Time for Trixie to haul out her (updated) stats, and deliver another scathing speech.

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I am confused about the gastroenteritis outbreak. 

At the end, Dr. Turner said it was an E. coli gastroenteritis brought in by one of the patients.  This type of infection is not airborne, it is caused by eating contaminated food/water or passed on by handling stool from an infected person and insufficient hand washing.

One would presume, at the maternity home, that good hand washing was the norm.  How did it pass through all of those women and babies? Nothing was said about it being a public health crisis and investigating the water source for the materinity home or the neighborhoods.

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I didn't understand how the E. coli breakout happened, either. At first I thought it had something to do with the twin girls, since we saw the dad put something on their lips. I thought maybe it was inadvertently contaminated. Then we get an almost throwaway line later on from Dr. Turner that it was a patient who'd been discharged before the time of the show. 

Trixie and Matthew's phone call was surprisingly sexy. Just goes to show you don't have to be explicit to make something erotic. 

I have a niece with Down syndrome, and she's at risk for a lot of things simply because of that. I figured they wouldn't make Reggie too sick, but when they showed him losing his hair, I did hold my breath a bit.

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2 hours ago, Orcinus orca said:

Pompous Ass:  With respect, Sister.

Sr. MJ:  I hear no respect in your tone.

You go, girl!

"I hear no respect in your tone, only the adverse." LOL.

So the new-fangled gizmo for pulling out the baby is basically a suction cup?

Nonnatus House has been under threat of closure for as long as I can remember. But I do wonder if maybe they're thinking of winding down now that they're 12 seasons in.

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1 hour ago, Haleth said:

Yeah, the E. coli outbreak made me wonder if the health board was questioning the wrong staff at the wrong facility. Was someone a little lax about cleanliness?

I was confused by it too. My cat had gastroenteritis due to something he ate. I was also a lab tech and am familiar with E. Coli. 

2 minutes ago, iMonrey said:

"I hear no respect in your tone, only the adverse." LOL.

So the new-fangled gizmo for pulling out the baby is basically a suction cup?

Nonnatus House has been under threat of closure for as long as I can remember. But I do wonder if maybe they're thinking of winding down now that they're 12 seasons in.

Yes, it has been..... they need to drop this threat every season. 

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Has the show ever gone into why the board of health is so hostile toward Nonnatus House? Is it basically men being misogynist?

I was also a bit surprised that continuing education wasn't required for health professionals. 

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10 minutes ago, dubbel zout said:

I was also a bit surprised that continuing education wasn't required for health professionals. 

Itis  now but it wasn't back then. I graduated from nursing school in 1971 and mandatory continuing ed was not a state mandate until halfway through my career.  The hospitals had yearly mandatories but were generally recerification on CPR and fire safety and when  new equpiment was brought in.

10 minutes ago, dubbel zout said:

Has the show ever gone into why the board of health is so hostile toward Nonnatus House? Is it basically men being misogynist?

Doctors have a long history of that behavior toward anything managed by females and nurses in general. I remember when the expectation was that a nurse was expected to give up a chair to a physician at the nurses station.

Edited by Orcinus orca
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At the very beginning, they showed the woman who had just given birth.  Shelagh told her three rambunctious kids, "There's a chair here for each of you."  They all three promptly plopped themselves on the bed.  Mom (or maybe Shelagh) asked them if they had washed their hands before they could hold the baby.  They sheepishly grinned and nodded. 

I think that was the clue as to how the e-Coli was introduced to the hospital.  How it traveled from there, I'm not sure - but that's how it came in - IMO.

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Sr. MJ was also the one who spotted the baby wasn't breathing and called for backup. When they write her as elderly, but not completely dotty, she's a valuable asset to Nonnatus House.

This felt like an old-school episode with lots o' nursin' and birthin' and lots of plot signals laid in: woman doesn't want a home birth...of course she's having a home birth.

It felt out of character for Violet to think Reggie was being lazy. She loves him very much, and you think she'd notice he was feeling poorly. Cyril turned out to be a very good friend and a wise pastor.

Changing times have been a major theme for the show since it began in post-WWII recovery, til the current Swinging '60s. The historical time period makes great change inevitable.

Whatever happened to the real-life Nonnatus House, I hope they keep the fictional one alive and working for years!

 

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37 minutes ago, AZChristian said:

I think that was the clue as to how the e-Coli was introduced to the hospital.  How it traveled from there, I'm not sure - but that's how it came in - IMO.

 

I do believe that is how they are saying it got inroduced but since the moms and babes were basically bed bound someone was passing it around to them. (unless the moms are able to get up to go to the bathroom and someone didn't clean the bathroom). Shelagh was the nurse who got sick... Shelagh is the big "wash hand" stickler but something broke down somewhere. Either their autoclave wasn't working to sterilize properly or someone wasn't washing their hands, they didn't make that clear.

 

1 hour ago, libgirl2 said:

I was also a lab tech and am familiar with E. Coli.

 

 

me too!!

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56 minutes ago, Blackie said:

 

I do believe that is how they are saying it got inroduced but since the moms and babes were basically bed bound someone was passing it around to them. (unless the moms are able to get up to go to the bathroom and someone didn't clean the bathroom). Shelagh was the nurse who got sick... Shelagh is the big "wash hand" stickler but something broke down somewhere. Either their autoclave wasn't working to sterilize properly or someone wasn't washing their hands, they didn't make that clear.

I remember in one scene, Shelagh was very industriously smoothing out the top sheets of a bed as she made it.  If those were sheets that HAD been on the bed of the mother with all the kids, perhaps the water wasn't hot enough when they were washed.  (One possibility.)

I envisioned those kids being the type to go to the bathroom, not washing their hands, and touching everything possible everywhere they go.  I've seen unmonitored kids picking up five forks out of a container at a breakfast bar at a hotel, and then putting four of them back into the container.  Mom and Dad were totally oblivious.

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50 minutes ago, kwnyc said:

Sr. MJ was also the one who spotted the baby wasn't breathing and called for backup. When they write her as elderly, but not completely dotty, she's a valuable asset to Nonnatus House.

This felt like an old-school episode with lots o' nursin' and birthin' and lots of plot signals laid in: woman doesn't want a home birth...of course she's having a home birth.

It felt out of character for Violet to think Reggie was being lazy. She loves him very much, and you think she'd notice he was feeling poorly. Cyril turned out to be a very good friend and a wise pastor.

Changing times have been a major theme for the show since it began in post-WWII recovery, til the current Swinging '60s. The historical time period makes great change inevitable.

Whatever happened to the real-life Nonnatus House, I hope they keep the fictional one alive and working for years!

'

I watched the show when it aired originally, and I'm not sure anyone would have asked a person with Down Syndrome for permission to do anything.  If someone were reasonably high functioning like Reggie,  maybe they would explain what they were doing, but that's about it.  

I also wonder if Daniel Laurie might have been diagnosed with hypothyroidism and they decided to write it into the show.

 

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16 hours ago, JustDucky said:

As long as they keep renewing this series, I will take threats against Nonnatus House with a grain of salt.  The finale of the entire show won't even show the closing, I think - just a "what happened after" scene and end it all happily (although we'll all cry buckets).

I think the closing of Nonnatus House will be the series finale. It's the end of an era. 

6 hours ago, Blackie said:

 

OMG I almost had a panic attack when he said he was so tired and losing hair.

My first thought was leukemia as well, so I was relieved that it was something far less serious. 

@JustDuckyIn the train crash, Timothy was mistaken for a fully trained doctor when he was bringing Dr. Turner's white coat to him. Timothy decided to help. I'm not sure if that's what you're looking for. 

16 hours ago, Badger said:

Right before Mr. Khatri comes by and asks about his wife and the babies, Dr. Turner and Timothy are outside talking.  Timothy says that Trixie is back in the nursery and that she hasn't had any sleep.  He asks his father how do you do it.  Dr. Turner asks me or Nurse Franklin.  Timothy answers all of you and myself too when the time comes.  He asks how do you see death coming so close, chase it away and then move on as if nothing exceptional has happened.

Dr. Turner says because in this job, you get used to exceptional things and that's the terror and privilege of it.

I wish we could have seen this scene. It sounds fantastic. 

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7 hours ago, Blackie said:

OMG I almost had a panic attack when he said he was so tired and losing hair. I think some leukemia's are more common in people with Down Syndrome, but then I remembered they  recently did a leukemia story so it probably wasn't that,

I'm glad the all the plotlines turned out as well as they did in the end. In addition to also thinking that Reggie had leukemia, I was sure at least one of those babies was going to die from the E.coli infection. It can cause Hemolytic Uremic Syndrome which still today has a very high mortality rate. Fortunately, they didn't go there.

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1 hour ago, Badger said:

I also wonder if Daniel Laurie might have been diagnosed with hypothyroidism and they decided to write it into the show.

 

Another big tell with hypo is weight gain; he did look bigger. Maybe Laurie does have it. 

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4 hours ago, LtKelley said:

And there wasn't tremendous support from the community and the show does hint at that.

The entire community signed a petition to allow Trixie to speak at that meeting. Your expressed POV has allowed me to understand why this “board” is persecuting NH, specifically. However, Phyllis merely suggested that she viewed every new device, practice, medication, etc., with a healthy amount of caution (keeping it in mind until empirically proven), ass well she should. I would think that diligence alone would prove her capable.

 I myself, am very leery of the latest and greatest touted these days in health care. Pharmaceuticals, medical devices and procedures advertised to the public often end up a few years later in class action lawsuits against the manufacturers (if you or a loved one…). The FDA can no longer be trusted because they’ve decided that the “peer reviewers” (for the peer-reviewed studies that support the acceptance/approval are not shown the raw data gathered, only the conclusions of the authors, so they cannot possibly contradict the conclusions). One only needs a thorough course in statistics to understand this.

Remember, it wasn’t that long ago that Dr. Turner had to face the very real effects of Thalidomide. I could very well have been affected by that (exact time frame and a nauseas mother) save for a minimalist family practitioner (who wouldn’t even consider a tonsillectomy, disregarding near monthly bouts of strep-he was right, I grew out of it).

As for “the control issue”, I heartily agree! 

Edited by Daff
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4 hours ago, Blackie said:

 

I do believe that is how they are saying it got inroduced but since the moms and babes were basically bed bound someone was passing it around to them. (unless the moms are able to get up to go to the bathroom and someone didn't clean the bathroom). Shelagh was the nurse who got sick... Shelagh is the big "wash hand" stickler but something broke down somewhere. Either their autoclave wasn't working to sterilize properly or someone wasn't washing their hands, they didn't make that clear.

 

 

 

me too!!

A physician friend once told me: “The world is covered in a thin layer of stool, so best remember that at all times.”

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7 minutes ago, LtKelley said:

But multiple mothers have been talking about wanting hospital births -

Yes, and we all know that’s the way SOP went over the years. Unfortunate that they included a story in this particular episode where one of the mothers was dealing with moving her household at the exact delivery time (she just wanted a HOME, and that seemed to distract her from making an actual decision on where to give birth). In the end, she was effusively pleased, so much so that I thought she’d defend Phyllis at the board.

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3 hours ago, AZChristian said:

I remember in one scene, Shelagh was very industriously smoothing out the top sheets of a bed as she made it.  If those were sheets that HAD been on the bed of the mother with all the kids, perhaps the water wasn't hot enough when they were washed.  (One possibility.)

 

That could possibly be but then Shelagh needs to be washing her hands before handling the babies or doing any medical exam of the mother or eating her lunch.

Although.... I was just reading online that most Ecoli infections in babies are contracted from mother during birth. Maybe if all these families live in the same area there is something in their water supply???   Still doesn't explain how Shelagh got it other then she didn't wash her hands before she eating. Also she went home and spread it to all her kids!!!!!  I am losing confidence in Shelagh!!!!

I wish there was more follow up about where they think it came from, or maybe it was more common in that area in those days because of poor living conditions. 

 

2 hours ago, eel21788 said:

I was sure at least one of those babies was going to die from the E.coli infection. It can cause Hemolytic Uremic Syndrome which still today has a very high mortality rate. Fortunately, they didn't go there.

 

That is usually from a different strain of E Coli , it causes bloody diarrhea. This strain is still very serious and a newborn can die of dehydration.

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1 hour ago, LtKelley said:

Agreed but I can also see where the medical doctor who was teaching the class just might take offense

Again, as a new nurse close to that time period, doctors took offense at practically ANY suggestion from a female nurse.  You were put in your place pretty damned quickly. Nurses were expected to follow orders and keep their mouths shut. 

Luckily I ended up working with a progressive neurosurgeon who was remarkably dependent on our observations - as he said, we spent 8 hours with his patients while he spent 8 minutes.

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3 hours ago, Daff said:

The FDA can no longer be trusted because they’ve decided that the “peer reviewers” (for the peer-reviewed studies that support the acceptance/approval are not shown the raw data gathered, only the conclusions of the authors, so they cannot possibly contradict the conclusions).

Peer reviewed publications aren’t used for FDA approvals.  Companies submit all of the raw data to the FDA, and FDA staff review *everything* (I know because I’ve been asked to provide information during the review).  Once the FDA has finished their review, FDA scientists make recommendations to the expert committee of non-FDA staff who vote on whether something should be approved or not.  All of those reviewers can have access to the raw data if they want it.  The FDA then takes the recommendation under advisement and makes the final decisions.

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3 hours ago, Daff said:

Remember, it wasn’t that long ago that Dr. Turner had to face the very real effects of Thalidomide.

Exactly. Even if she hadn't been cautious or skeptical before, I can easily understand how Thalidomide would have made anyone question that what was promised to be the most amazing, latest, greatest medical advancement might actually have some significant drawbacks and side effects that were not yet known. 

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3 hours ago, Blackie said:

That is usually from a different strain of E Coli , it causes bloody diarrhea. This strain is still very serious and a newborn can die of dehydration.

They showed one of the nurses changing a bloody diaper. She referred to it as a "severe tummy upset."

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9 minutes ago, eel21788 said:

They showed one of the nurses changing a bloody diaper. She referred to it as a "severe tummy upset."

They all looked like yellow mustard to me. 

*Graphic Details Ahead * When I worked in lab we got the samples so I have seen everything from yellow mustard (which is what that looked like) to pretty much pure blood. (and EVERYTHING inbetween)  Sorry TMI

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37 minutes ago, Blackie said:

When I worked in lab we got the samples so I have seen everything from yellow mustard (which is what that looked like) to pretty much pure blood.

And I am the nurse that collected, packaged, and sent them!  We've seen some "stuff"...

8 minutes ago, 3 is enough said:

Cyril is the best.  Reggie is lucky to have him as a friend/ mentor. 

I am glad they are finding stories to keep Cyril employed.  Not sure how long they can stretch it, though.

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11 hours ago, Orcinus orca said:

And I am the nurse that collected, packaged, and sent them!  We've seen some "stuff"...

I am glad they are finding stories to keep Cyril employed.  Not sure how long they can stretch it, though.

I was doing my hospital lab rotation. Right after I was done with microbiology section, there was an outbreak of salmonella in our area. The poor woman who was in that section pretty much saw "samples" all day. I was glad to be out of there. 

I love Cyril and really want him to hang around. 

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I’ve recently caught two episodes of this show after a long break.  I was surprised that Fred and Violet didn’t figure out that Reggie should see a doctor after repeated complaints of exhaustion.  
 

What’s the scoop on Trixie and her boyfriend?  All seemed promising.  
 

I’ve given up on the Sister Monica Joan writing.  I sense they regret writing her with severe dementia long ago.  It doesn’t make sense that she’s so keen now.  And, it’s unfair to people who actually have dementia and their families to portray it that way.  I try to pretend it didn’t happen.  

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1 hour ago, SunnyBeBe said:

I’ve given up on the Sister Monica Joan writing.  I sense they regret writing her with severe dementia long ago.  It doesn’t make sense that she’s so keen now.  And, it’s unfair to people who actually have dementia and their families to portray it that way.  I try to pretend it didn’t happen.  

They really have to regret having her with dementia 10 years ago.  It's pretty annoying that she often has the "words of wisdom" now.  That's a really good point about being unfair to those with dementia.

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3 hours ago, Suzn said:

They really have to regret having her with dementia 10 years ago.  It's pretty annoying that she often has the "words of wisdom" now.  That's a really good point about being unfair to those with dementia.

If I remember correctly, the character in the first book had dementia and in the early days of the series, they went by the books, mainly the first one. Maybe they weren't even sure it would take off like it did and be on for so long? 

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1 hour ago, libgirl2 said:

If I remember correctly, the character in the first book had dementia and in the early days of the series, they went by the books, mainly the first one. Maybe they weren't even sure it would take off like it did and be on for so long? 

I'm sure that's the case. I just wish that they would not go back and forth on the dementia.  When it became apparent that the show had legs, they could have just pretended that the dementia had never been the case.  They could then move forward with some consistency.  Although, I have to say that even though I like Judy Parfitt, Sister Monica Joan needs to go to the mother house to stay now.

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I have no issue with the actor. I just have issues with portraying a person with dementia as if they recovered and are now very wise and competent indeed.  Perhaps, an explanation that it was due to a nutritional deficiency would have sufficed.  That kind of cognitive decline can be reversed.  But other causes, like Alzheimer’s or Vascular dementia would have resulted in progression by now and likely  her death.  So, eloquent speeches about the virtues of seniors, while touching, aren’t very believable, imo.  

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Well, let's face it CTM has put a happy spin on most of the stories which is quite unlike reality.  So take it for what it's worth, mostly fiction.  I love Sr. MJ so I don't mind a bit, a;though Evangeline was my absolute favorite closely followed by Phyllis (who I hated at first) so I just roll with it.

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1 hour ago, SunnyBeBe said:

I have no issue with the actor. I just have issues with portraying a person with dementia as if they recovered and are now very wise and competent indeed.  Perhaps, an explanation that it was due to a nutritional deficiency would have sufficed.  That kind of cognitive decline can be reversed.  But other causes, like Alzheimer’s or Vascular dementia would have resulted in progression by now and likely  her death.  So, eloquent speeches about the virtues of seniors, while touching, aren’t very believable, imo.  

You said it all better than I did.  It would have been wonderful if they had done as you suggested and had them find a reversible condition and had her recover.  As it has been, her condition changes from one plot need to the next.

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