"My First Day" is the 591st episode of Casualty and the first episode of the 22nd series. It was preceded by "To Love You So" and followed by "Charlie's Anniversary". This episode marks the first appearances of Ruth Winters and Toby De Silva, portrayed by Georgia Taylor and Matthew Needham, respectively.
It’s the first day in Holby City ED for new F2 doctors Toby De Silva and Ruth Winters. They are shown around the department by a rather disillusioned Charlie. While Ruth oozes confidence poor Toby manages to screw up nearly every job he’s given, including letting overdose victim Sunny go without treatment. A despairing Maggie sends Toby out with Dixie in the RRV. As they drive past a coach parked outside a row of shops there’s an almighty explosion.
Toby and Dixie run to help but they quickly become separated. Toby tries to suppress his horror at the carnage facing him and begin to assess the victims. When the medical teams arrive Toby is forced to help Maggie amputate a young man, Matt’s arm in order to rescue his mother, Christine, trapped beneath the debris. Alone again Toby finds a little girl, Rayne, trapped in another part of the collapsed shops. He carries her out but is immediately confronted by her distraught father, Rob, who takes the little girl and runs, ignoring Toby’s pleas to reunite the girl with her injured mother.
Toby takes Charlie’s car and drives off in search of Rayne. He cannot find her but instead spots Sunny. He is determined not to let Sunny go again and begs him to return to the ED for treatment. Sunny fights Toby off and runs. Toby returns to Charlie’s car to find it wrecked. Back in the ED, Toby finds himself in the midst of the majax crisis but he struggles to be helpful. When an MI patient, Jo, dies in his care – Toby can’t cope any more and leaves. Even meeting Sunny who has finally come in to be treated doesn’t change his mind and Toby walks away, feeling lighter with every step.
That is until he spots Rob carrying a clearly very ill Rayne. Toby takes her from him and realises the little girl is diabetic. He runs with her to a chemist and immediately gives her an IV injection of dextrose, saving her life. When the ambulance arrives to take Rayne in Dixie offers Toby a ride back. Toby realises he is a doctor after all and climbs into the back of the ambulance.