Note: This episode contains references and depictions of domestic abuse and suicide.

While everyone wishes they could permanently camp out at the sunny beaches of England all summer, it’s time for a #realitycheck back to work. Although, it is quite possible the Turners won’t have any desire to hit up the coast anytime soon…

Exam season is officially underway for the pupil midwives which is unleashing a certain level of anxiety for one particular student. Cyril is continuing his role as Poplar’s Child Welfare Officer, while Matthew is grappling with some ostensibly ominous news. What exactly is he up to?

Grieving a Family Member

A somber light casts over the Bell residence as the family patriarch quietly passes away in his sleep. Gladys Bell, the man’s daughter, is present by his bedside, along with Dr. Turner, Sister Monica Joan, and Nurse Crane. But somewhat surprisingly, Gladys doesn’t appear to be overly bereaved by her father’s death – not because she didn’t love him, but rather that she has “other things to get on with,” such as collecting money from debtors. Even when her son, Jason, comes into the room and sees the sight of his deceased grandfather, Gladys reminds him, “Tears are just time wasters.”

Later that day, Gladys decides to pack up her father’s belongings; sentimentality is not her strong suit. The ever-prudent Sister Monica Joan tries to offer Gladys some wisdom, telling her that one should allow space and time to grieve those you love. However, according to Gladys, she’s never paused in her life, nor is she planning on doing so now.

Two Abandoned Children

At the Turner home Shelagh and Sister Veronica discuss some ambitious plans for the children’s upcoming choral piece. Sister Veronica proposes that a challenge has never hurt anyone (though, she may have different thoughts once her ears start ringing).

Meanwhile, over at St. Oswald’s Church, the local vicar finds quite the surprise. He comes across a sight that stops him in his tracks: two tiny children sitting alone on the altar, with no adults or supervisor in sight. All they have is a handwritten note and red ribbons tied around their wrists.

The priest runs to Sister Veronica to inform her of his findings. She reads the note and confirms that the two boys have been abandoned. After introducing herself to the older brother, Tommy, Sister Veronica tells the priest and Shelagh that they must call the police immediately.

Cyril Steps In

Cyril, alongside WDC Grayson, joins Dr. Turner and the two abandoned boys at the police station. According to Dr. Turner’s assessment, both children have nits and scabies; all in all, though, their conditions are fairly healthy with no suggestion of malnourishment. He believes someone has been trying their best to care for the little ones.

WDC Grayson asserts that the situation is a clear case of child abandonment – a crime – and will be pursued as one. While the investigation is underway, Cyril brings Tommy and his younger brother to a temporary foster care facility. Mrs. Simms, one of the employees, remarks to Cyril that she hopes someone ends up coming forward and claiming them. Otherwise, she fears there’s a high chance the brothers could get split up.

Over at the church, Shelagh gives her first run of Sister Victoria’s choral arrangement. Major yikes! Time to pull out the earplugs, everyone.

Gladys Feels Ill

True to her word, Gladys Bell doesn’t wait a beat to collect the money she’s owed. After threatening one of her borrowers to pay up, Gladys pauses against a brick wall to catch her breath. Based on the agonizing grimace on her face, it appears she’s suffering from a strong stomach pain.

At Dr. Turner’s office, while retrieving her father’s death certificate, Gladys experiences the same type of pain again. Dr. Turner insists she sit in for an examination, though Gladys is reluctant at first. 

Soon after assessing her stomach, Dr. Turner submits an urgent referral for Gladys to see a gynecology specialist at St. Cuthbert’s. Mrs. Bell tries to brush away the doctor’s concern – she has other things to deal with – but Dr. Turner won’t have any of it. She must prioritize her health so they can get a better understanding of what illness she’s up against.

Matthew Faces the Board

For the past couple of weeks, a dark cloud has hovered over Matthew, though he has said little to nothing about the causes of it. At a board meeting for Aylward Estates, the truth finally comes out: Matthew has, more or less, brought the company to the brink of financial ruin. To be more precise, under his operations, the company has acquired more than £250,000 in debt. (Fortunately, due to an emergency reserve and generous donation from Matthew’s mother, Aylward Estates has managed to stay afloat).

But that’s where the good news ends for Matthew. Matthew’s mother informs her son that the board has ruled to remove him from his role and seat… and on top of that, his salary is completely stripped. Just like that, he is both without a job and security.

After the devastating board meeting, Matthew catches a brief moment with his mother. He doesn’t try to beg for any concession, but tells her he tried to do the best he could. His mom sympathizes slightly, but says the reason for the company’s near-cataclysmic downfall was due to his poor business-making decisions. Ouch.

While Matthew sits with his new predicament, Gladys decides to show up to her gynecology appointment. However, the specialist doesn’t view Mrs. Bell’s ailment as a gynecology issue: She is to go immediately to the third floor to have her abdominal examined. Similar to her interaction with Dr. Turner, Gladys attempts to downplay the gynecologist's wave of concern. But this is a serious matter – and nothing on the doctor’s face suggests this is a trivial subject.

Matthew Comes Clean to Trixie

An irritated Trixie sits on the couch as Matthew finally returns home. He was supposed to meet her at the showroom earlier but never showed up. At long last, Matthew confesses to his wife the state of his business affairs.

Trixie learns there will be no second car and that her husband is now in a precarious financial situation. Matthew tells her that he kept trying to make things right, but due to the risks and investments he made, he’s lost everything he’s ever worked for.

Fortunately, Trixie is quick to show compassion and support to her husband. Yet, at breakfast the next morning, she learns of another bombshell: the family won’t in fact be moving to the new apartment in the Barbican as Matthew can't afford the mortgage. This time, it’s not so easy for Trixie to put on a brave face.

Nurse Crane Encourages Rosalind

Amidst the hustle and bustle of the pupil midwives’ busy work days, they are also in the home stretch of preparing for their final exams. Out of the four women, Rosalind demonstrates the most anxiety over her upcoming assessment. Late one night, Nurse Crane accidentally walks in on Rosalind in the bathroom… studying her books on the toilet.

Rosalind appears to be the most nervous about the oral part of the exam where she must present in front of a panel. Nurse Crane tells the young pupil that to excel at this portion, she must learn how to speak up for herself, something that Rosalind doesn’t feel fully equipped to do.

Nevertheless, Nurse Crane offers her help in the form of none other than gym exercises! Marching in place, arm circles, jumping jacks – you name it. While Rosalind seems less than thrilled by Nurse Crane’s daily exercises, there’s no denying the benefits of how exercise and activity can relieve stress in the brain. Strong points, Nurse Crane.

Gladys' Diagnosis

Gladys’ test results from St. Cuthbert’s finally arrive, and they are worse than feared. Dr. Turner reads that Mrs. Bell has a rare form of abdominal cancer that can’t be treated with curative intent.

Dr. Turner decides to visit Glady’s home to check up on her. He runs into Jason, a prospective professional soccer player, kicking the ball outside. He seems to be under the impression that his mother has been “cured” of her illness. Confused and concerned, Dr. Turner enters the house where he finds the mother. She seems relieved that the scouts for West Ham United's youth team scouts are impressed with Jason… as well as largely uninterested in discussing her diagnosis.

Gladys feels as though she is in a position where no one can help her, where nothing can be done. Dr. Turner assures her that while she can’t be cured, he and the larger medical staff will help and care for her during the coming weeks and months. He also tells her that she’s eligible to join a study focused on asbestos-related cancer; she agrees to go, but only under the condition that no one tells her kids about her diagnosis. She doesn’t want them to carry the burden of the news – they “have things to do.” 

A Distraught Expectant Mother

Near the shipping docks, onlookers find an ill-looking, pregnant woman passed out by the water’s edge. Moments earlier, it looked as though she was mere inches away from stepping off the cliff edge – in an implied suicide attempt – but at the last minute, pulled back and collapsed onto the ground.

Fortunately, Trixie and Rosalind happen to be pedaling on their bikes and notice the frenzied gathering. They rush to the woman, who they learn is named Deirdre. She’s brought to the maternity ward where Dr. Turner evaluates her. Deirdre is past her due date by four days, has scabies, and has a rapid heartbeat. And when Rosalind looks through the expectant mother’s coat pocket, she discovers a red ribbon… she's the mother of the two boys.

Deidre weeps about her guilt for abandoning her two sons, but based on the mother’s current state, one can understand a sense of the desperation she was facing. In the hallway, Dr. Turner discusses with Rosalind and Trixie about the next steps for the patient. He doesn’t want any police intervening until he says so; the distressed mother needs care. In the meantime, she doesn’t appear strong enough to go into labor right now.

While a psychiatrist is called from St. Cuthbert's to assess Deirdre, Rosalind is given the task of bathing her. The pupil midwife offers Deirdre some reassuring words, telling her that she doesn’t doubt the mother did everything she could to care for her children. But when Rosalind removes Deirdre’s shirt, she finds a frightfully appalling sight: an array of bruises scattered along the mother’s back. Deirdre explains that back in Ireland, her husband hit her brutally with a belt buckle. Following this physical violence, she took her children with her and left Dublin – fearing they were potential next victims. 

Attending the Asbestos Study

Gladys attends the “Industrial Asbestos Workplace Study” with Dr. Turner at St. Cuthbert’s Hospital. Based on the anecdotal information Gladys provides, the researcher hypothesizes that Gladys' father exposed her to asbestos as he was a drill operator who likely worked near carcinogens without knowing.

The research team doesn’t have any current cases of secondary exposure, thereby making Gladys an excellent candidate for trying newly available injections. She is told that they could prolong her life by several months – however, she emphatically turns the offer down, citing she no longer has a fight left in her.

Meanwhile, over at the maternity ward, Cyril visits the recovering Deirdre. He learns that when Deirdre came to London, she tried to support her two boys on her own, but eventually, was kicked out of her apartment for failing to make the rent. With nowhere else to turn, she made the painful decision to leave her children at the Church.

Cyril promises Deirdre he will try to do everything he can to help. However, when she asks whether she could have her boys back, he is unable to give her a decisive answer. Later on, Cyril tells Rosalind that her two boys are on course to be moved to more permanent foster homes and that he fears that her baby may be taken from her too.

Trixie and Matthew Argue

In an attempt to help Matthew and their financial predicament, Trixie calls a friend to see if there are any job opportunities her husband could take up. It turns out there may be a solid lead, but in relaying this information to Matthew, he becomes quite, quite agitated. He feels that Trixie went behind his back by letting people know of their situation, to which she counters that he left her in the dark for months. From his perspective, though, he was “shielding” her from the truth.

Both of them are rightfully upset for different reasons, although Matthew makes a point of noting how for Trixie, “money… is just something that pays the way for happiness.”

Sooo, where exactly does the couple go from here?

Rosalind Oversees Deirdre’s Delivery

On a sunny park day, Deidre is joined by Rosalind on a bench. The mother is at long last reunited with her two boys and it’s evident how much she has been longing for this moment.

A little while later, as Deidre is playing on the grass with her sons, she begins to experience the beginning pains of labor. At the maternity ward, Sister Julienne oversees Deidre’s delivery with Rosalind. After past moments of doubt and hesitation, Rosalind’s time to shine finally arrives. She takes the lead – choosing to rupture the mother’s membranes in order for the baby to drop more – and helps Deirdre give birth to a baby girl. Sister Julienne can’t help but look on proudly at the pupil. 

Becoming Sicker

After Gladys breaks the news to her kids about her diagnosis, Jason also discovers she rejected offered treatment injections. He’s heartbroken and vexed by this revelation, and later on, ends up getting into a scrap with people during football practice.

Dr. Turner tends to his injury – just a finger sprain – while Gladys watches on, pointing out how frivolous it is for Jason to act out when he has a potential career ahead of him. After the teenager leaves the office, Dr. Turner tries to remind the mother that he is struggling. While he may appear tough, he is young, and at the end of the day, he just wants more time with Gladys.

After having a brief run-in with a teary-eyed Jason on the street, Sister Monica Joan drops by the Bell’s residence to check on Gladys. Sister Monica Joan encourages Gladys to consider fighting back against her cancer – even if it’s to live for just one extra second with those she loves. Gladys has never been one to cower from a challenge: she has always been fearless.

Taking Sister Monica Joan’s words to heart, she elects to try the radiation treatment, accompanied to her appointment by none other than her loving son, Jason.

Cyril Comes to a Solution

Cyril finds himself at a standstill: How does he do right by Deirdre while also providing the safest, best options for her children?

He winds up sitting in a pew at church, lingering in his thoughts. Shelagh runs into him, having arrived early to practice the children’s choral arrangement ahead of the performance. She asks Cyril whether he’s been thinking about the children’s situation. He tells her that he’s concluded there is no perfect solution. He got into the line of work to help families, but all he feels he’s doing is breaking them apart.

Shelagh offers her personal experience and affirms that solutions don’t have to be perfect – rather, they just have to work. This advice seems to click for Cyril, and he goes to finally inform Deirdre of his recommendation. The welfare office will assign Deirdre some housing accommodations and will be able to keep her newborn baby. However, for the time being, her two other boys will have to remain in foster care until Deirdre can prove she’s able to cope on her own. It’s not ideal news for the mother, but it’s a step in the right direction, and one that provides hope for her future.

Exam Results

Exam day is finally here for the pupil midwives! With the writing portion out of the way, it’s time now for Rosalind to face the oral response section. While she’s undoubtedly buzzing with nerves, she looks at the red ribbon in her hand to provide her with a boost of confidence. She’s got this – and gives a confident, grounded answer to her proctor.

The test results eventually arrive, and low and behold, all four pupil midwives pass with flying colors! Sister Julienne offers Rosalind and Joyce full-time positions at Nonnatus House on the spot – yippee! There’s tons and tons of hugging to be had.

Though, while the much-deserved celebrations are underway, some potentially unsettling news has been uncovered. Trixie learns from Matthew that he never actually signed the deeds to Nonnatus House over to the Order’s name. Is the security of Nonnatus House once again at risk? I guess we’ll just have to wait ‘til next week to see.

Forgot how we got here? Catch up on “Call the Midwife” with the Season 13, Episode 5 Recap.